When body mass index fails to measure up: perinephric and periumbilical fat as predictors of operative risk - 18/04/17
Abstract |
Background |
Obesity has been associated with worse outcomes and increased surgical technical difficulty. Perinephric fat (PNF) and periumbilical fat (PUF) are alternative metrics to body mass index. We hypothesized that PUF and PNF would offer improved prediction of perioperative risk.
Methods |
249 patients were retrospectively reviewed after elective, pelvic colorectal resections. PNF and PUF were collected using axial imaging. Operative risk measurements included estimated blood loss (EBL) and operative time (OT).
Results |
In multivariate analyses of women, PUF and PNF were significant predictors of EBL; PNF was a significant predictor of OT. A 4.7-mm increase in PNF predicted a 15-minute increase in OT and 55-cc increase in EBL. An 8.6-mm increase in PUF predicted a 55-cc increase in EBL. In men, no metric was predictive.
Conclusions |
In women, PNF and PUF may offer improved metrics for risk stratification, which can have important clinical and financial implications.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Alternative fat metrics to BMI are proposed: perinephric fat (PNF) and periumbilical fat (PUF). |
• | In women, PUF and PNF were predictors of blood loss, and PNF of operative time. |
• | PUF and PNF are quickly and reliably obtained from axial imaging. |
• | PUF and PNF may offer improved metrics for risk stratification. |
Keywords : Body mass index, Colorectal surgery, Periumbilical fat, Perinephric fat, Perioperative risk assessment, Obesity
Plan
| There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs. |
|
| The authors declare no conflicts of interest. |
Vol 212 - N° 6
P. 1039-1046 - décembre 2016 Retour au numéro
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- Table of Contents
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