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The Association of Body Mass Index with Postoperative Outcomes After Elective Paraesophageal Hernia Repair

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

A Correction to this article was published on 29 April 2019

This article has been updated

Abstract

Purpose

To evaluate the association between body mass index (BMI) and postoperative outcomes in elective paraesophageal hernia (PEH) repairs.

Methods

A retrospective review of patients who underwent elective PEH repair in the ACS NSQIP database (2005–2015) was performed. Patients were stratified into BMI groups (< 18.5, 18.5–24.9, 25.0–29.9, 30.0–34.9, 35–39.9, and ≥ 40.0 kg/m2) according to the World Health Organization classification criteria. A multivariable logistic regression model was developed to characterize the association between BMI class and outcomes, including readmission, reoperation, postoperative complications, and mortality.

Results

The median (IQR) age of the 9641 patients who met inclusion criteria was 64 (55–72) and 72.7% were women. Across each BMI class, age, race, gender, type of procedure, frailty index, smoking, and ASA class varied (p < 0.05). Underweight patients (BMI < 18.5 kg/m2) had an increased risk of mortality (OR = 6.35, p < 0.05). Patients with a BMI 35–39.9 kg/m2 (OR = 0.65, p < 0.05) and ≥ 40 kg/m2 (OR = 0.36, p < 0.001) were associated with a decreased risk for readmissions.

Conclusion

Underweight patients have an increased risk for postoperative mortality after elective PEH repair. Higher BMI was associated with a diminished risk for readmission, but not for mortality, reoperations, or overall complications.

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Change history

  • 29 April 2019

    In this paper, the first author���s name was incorrectly tagged.

  • 29 April 2019

    In this paper, the first author���s name was incorrectly tagged.

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Acknowledgments

We thank Joseph Giacolone, Dr. Robert Caskey, Dr. Ari D. Brooks, Dr. Octavia E. Pickett-Blakely, Dr. Noel N. Williams, MD, and Dr. Andrew Sinnamon for providing with insightful input to the study.

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Authors and Affiliations

  1. Department of Surgery, Division of Gastrointestinal Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA

    Samuel Torres Landa, Robert A. Swendiman, Chris Wirtalla, Daniel T. Dempsey & Kristoffel R. Dumon

  2. Department of Medicine, Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Jordana B. Cohen

  3. Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Jordana B. Cohen

Authors
  1. Samuel Torres Landa
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  2. Jordana B. Cohen
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  3. Robert A. Swendiman
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  4. Chris Wirtalla
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  5. Daniel T. Dempsey
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  6. Kristoffel R. Dumon
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Corresponding author

Correspondence to Kristoffel R. Dumon.

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Landa, S.T., Cohen, J.B., Swendiman, R.A. et al. The Association of Body Mass Index with Postoperative Outcomes After Elective Paraesophageal Hernia Repair. J Gastrointest Surg 22, 2029–2036 (2018). https://doi.org/10.1007/s11605-018-3853-3

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  • DOI: https://doi.org/10.1007/s11605-018-3853-3

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