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Postoperative complications in obese and nonobese patients first – Respiratory management of the obese patient undergoing surgery

Correspondence to Olumuyiwa A. Overweight and obesity.

Ethan Walker
Tuesday, November 20, 2018
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  • Cozier et al. Our study has several limitations, including its retrospective nature, which limited the accuracy of data to what was documented in electronic medical records.

  • J Cardiothorac Vasc Anesth ;—6.

  • Furthermore, the immediate post-operative period can pose an increased risk for respiratory complications in obese patients with OSA and OHS as opiate sensitivity contributes to the severity of nocturnal hypoxia 97 Obese patients are prone to vehicle accidents more than general population due to the associated sleep apnea.

  • The rate of postoperative complications was 7. Anesthesia for morbidly obese patients.

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Methods Study sample This study is a single-centre prospective analysis of postoperative complications in patients undergoing general surgery. Statistical Analysis Chi-square analysis did not reveal any significant differences in complication rates when subgroups were analyzed according to the WHO classification. Surgical risk was divided into low, intermediate and high-risk procedures as proposed by Boersma et al. Alokail, N.

Journal overview. The overall complication rate was highest in class III Research article Open Access Published: 31 July Obesity — a risk factor for postoperative complications in general surgery? Obesity has been considered as a risk factor for pancreatic diseases, including pancreatitis and pancreatic cancer.

ALSO READ: Health Effects Of Obesity Essay Spm

Download citation. World J. Arch Surg ;— Office of the Surgeon-General, Rutter MD, Olubukola O. Obesity is an independent risk factor for perioperative morbidity, and morbid obesity is a risk factor for mortality. Nathan B.

You can also search for this author in PubMed Google Scholar. Greengrass, and R. Jones, V. A chi-square test was used for all categorical variables.

View at: Google Scholar D. Almost all healthcare professionals are exposed to obese patients because of their higher risk for morbidity and mortality, and surgeons are not exceptions [ 1 ]. Park and J. Oreopoulos, R. Our findings suggest that a tendency to regard obesity as a major risk factor in general surgery is not justified.

Introduction

Obese patients have a significantly higher risk of postoperative myocardial infarction, wound infection, nerve injury, and urinary infection. A retrospective review and analysis of adult postoperative complications recorded on an electronic database was conducted. World J Surg ;—

Anesthesia for morbidly obese patients. Conclusions: Obesity is associated with significantly higher rates of complications after ORIF and TEA for distal humerus fractures than in nonobese nonobes. There is a scarcity postoperative complications in obese and nonobese patients first recent and reliable studies comparing postoperative morbidity and mortality in obese and nonobese patients. Keywords: Obesity; complications; distal humerus fractures; open reduction and internal fixation; total elbow arthroplasty. Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients. Results: A total of patients who underwent operative management of a distal humerus fracture were identified, including ORIF and TEA procedures.

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References 1. Conclusions: Obesity is associated with significantly higher rates of complications after ORIF and TEA for distal humerus fractures than in nonobese patients. Search SpringerLink Search. Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients. View author publications.

Surgery ;— Hemodynamic and respiratory changes in postoperatiive of the morbidly obese. Abstract Background Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients. The rates of postoperative infection, venous thromboembolism, and medical complications were significantly higher in the obese ORIF cohort than in nonobese patients. Rights and permissions Reprints and Permissions. Correspondence to Olumuyiwa A.

International Journal of Chronic Diseases

These cohorts were then queried for postoperative complications within 90 days after the surgical procedure using diagnostic and procedural codes. About this article Cite this article Bamgbade, O. J Cardiothorac Vasc Anesth ;—6.

  • When compared to patients of normal weight, the underweight patients had a higher ASA classification and a higher risk of postoperative complications. Generalized [ 2324 ] and central obesity [ 25 ] increase the risk of arterial hypertension.

  • Br J Anaesth ;—

  • There is an association between obesity and the presence of hiatal hernia [ ]. You can also search for this author in PubMed Google Scholar.

  • Office of the Surgeon-General, Br J Anaesth ;—

Herzog, S. Advances in clinical medicine can alter current practice. Obesity — a risk postoperatve for postoperative complications in general surgery?. Reprints and Permissions. Obesity is associated with reduced lung and chest wall compliance and increased lung resistance, which explains why these patients were less likely to successfully wean from the ventilator. Conclusion In conclusion, our findings suggest that a tendency to consider obesity as a major risk factor in general surgery is not justified.

  • There is an association between obesity and the presence of hiatal hernia [ ].

  • Br J Anaesth ;—

  • The current prevalence of obesity in the United States is Is body mass index associated with outcomes of mechanically ventilated patients in intensive care units?

  • Morbidly obese patients had a higher mortality rate of 2. View author publications.

  • Poirier, M.

  • All rights reserved. Arch Surg ;—

The database covered a period of 4 years and consisted of 7, cases of postoperative complications that occurred within 30 days of noncardiac moderate or major surgery. Office of the Surgeon-General, Tissue oxygenation in obese and non-obese patients during laparoscopy. Lancet ;— Methods A retrospective review and analysis of adult postoperative complications recorded on an electronic database was conducted.

In addition, obesity is highly associated with polycystic ovary syndrome and increases some of its features like hyperandrogenism, hirsutism, and infertility [ 75 ]. It can be responsible for the following cancer types [ 77 ]: i gastrointestinal system [ 78 ], ii hepatobiliary system [ 79 ], iii breast premenopausal [ 80 ] and postmenopausaliv endometrial, ovary, and cervix [ 81 ], v lung but not in current or former smokers [ 82 ]vi skin malignant melanoma [ 83 ], vii multiple myeloma [ 83 ], viii leukemia [ 83 ]. Wild, W. View at: Google Scholar K. Obesity: preventing and managing the global epidemic. Morbid obesity rates continue to rise rapidly in the United States. Additional file.

MeSH terms

Meacham R, Vieira F. Due to the potential increased perioperative risk in this population, anticipation of potential complications is crucial in providing appropriate surgical counseling and improving patient safety. Boggs, L. All authors approved of this submitted version of the article.

Obesity in anaesthesia and intensive care. Abstract Background: Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation ORIF and, more recently in elderly, low-demand individuals, total elbow arthroplasty TEA. Surgery ;— Anesth Analg ;— JAMA ;— Download references. Obes Surg ;

  • Bamgbade, T.

  • Patients in each operative group were then divided into nonobese and obese cohorts.

  • Thus, with exception of the complications described earlier, there was no difference in risk of any major postoperative adverse event between the obese and patients of normal weight.

  • Morbidly obese patients had a higher mortality rate of 2. Obes Surg ;

Bamba and D. Rosenberg, Y. Table 3. Download citation.

Obesity is associated with higher cancer incidence, recurrence, progression, and death [ 76 ]. This study reiterates the need for further investigation into the postoperative complications associated with varying classes of complciations as well as underweight patients. Table 1 shows the baseline and surgery related characteristics of the study population. Laparoscopic procedures are associated with shorter operative times, less blood loss, less postoperative pain and analgesic consumption, earlier postoperative recovery, shorter hospital stays, lesser degree of abdominal wall trauma, reduction in the rate of incisional hernia and pulmonary embolism, and better respiratory function and cosmetic results [ — ]. Chronic respiratory failure in these patients has been shown to be a consequence of a reduced hypercapnic ventilatory response at the end of an apnoeic episode Int J Obes.

Background

Arch Surg ;— Conclusions Obese patients have a significantly higher risk of postoperative myocardial infarction, wound infection, nerve injury, and urinary infection. You can also search for this author in PubMed Google Scholar. Bamgbade, O. Tissue oxygenation in obese and non-obese patients during laparoscopy.

Bamgbade, O. Monobese following surgery for duodenal ulcer in obese patients. Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem. The association of obesity with complications after either of these procedures has not previously been examined. Office of the Surgeon-General, There is a scarcity of recent and reliable studies comparing postoperative morbidity and mortality in obese and nonobese patients.

Olumuyiwa A. Obesity in anaesthesia and intensive care. Hemodynamic and respiratory changes in surgery of the morbidly obese. Obesity is an independent risk factor for perioperative morbidity, and morbid obesity is a risk factor for mortality. Office of the Surgeon-General. Published by Elsevier Inc.

Surg Endosc. Banerjee and L. Akiyama, M. Duthie, and D. Silventoinen, C. Renfrew, and W. Sandler, and E.

Reprints and Permissions. Tissue oxygenation in obese and non-obese patients during laparoscopy. Rutter MD, Olubukola O.

  • These phenomena serve to further increase work of breathing In simple obesity, subjects breathe more rapidly at a lower tidal volume to reduce the respiratory muscle load and avoid hypoventilation.

  • A retrospective review and analysis of adult postoperative complications recorded on an electronic database was conducted. Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem.

  • Cardiac disease refers to coronary artery disease with or without previous intervention, heart failure, arrhythmias, valvular heart disease or cardiomyopathy. Contact us Submission enquiries: bmcanesthesiology biomedcentral.

  • A number of recommendations are available to guide the clinician in the management of the obese patient undergoing surgery 4344 along with a number of useful websites see Table 1.

  • The higher the BMI body mass indexthe higher the risk for these complications.

  • About this article Cite this article Bamgbade, O. Abstract Background Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients.

Wilson, and N. The obesity paradox: body mass index and outcomes in patients undergoing nonbariatric general surgery. Multivariate regression analysis, adjusting for confounders, demonstrated that underweight patients undergoing general surgery again had the worst outcome HR 2. Steele, S.

You can also search for this author in PubMed Google Scholar. Issue Date : March Tissue oxygenation in obese and non-obese patients during laparoscopy. Actual causes of death in the United States,

Obesity-related changes in respiratory physiology

Since the beginning of this general teaching hospital contains a highly modern degree of automation and a reliable registration of the electronic medical record. The obesity paradox in patients with peripheral arterial disease. Review of medical records initially revealed patients, which were limited to based on exclusion criteria.

Aldoori, S. Obesity — a risk factor for postoperative complications in general surgery?. According to the World Health Organization, obesity has doubled sincewith a prevalence that is continuing to rise. Obesity contributes to a variety of psychological disorders in adults and children.

Postoperwtive by Elsevier Inc. Office of the Surgeon-General, Results The rate of postoperative complications was 7. Published : 29 August Patients in each operative group were then divided into nonobese and obese cohorts. Obesity is an independent risk factor for perioperative morbidity, and morbid obesity is a risk factor for mortality. Office of the Surgeon-General, 5.

A medieval medical view on obesity. Anesth Analg ;— World J Surg ;— The rates of postoperative infection, venous thromboembolism, and medical complications were higher in the obese TEA cohort than in nonobese patients. Download citation.

JAMA ;— Office of the Surgeon-General, 5. Issue Date : March Arch Surg ;— Abstract Background: Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation ORIF and, more recently in elderly, low-demand individuals, total elbow arthroplasty TEA. Olumuyiwa A.

Dominguezformulated research question, collected retrospective data, drafted and revised manuscript, approved final version. Finally, a recent meta-analysis 86 of pagients randomized studies of ventilation in obese patients, comparing pressure with volume ventilation found no difference between ventilation modes in terms of intraoperative oxygenation, tidal volume, mean airway pressure, mean arterial pressure and heart rate. Abstract Background Obesity is generally believed to be a risk factor for the development of postoperative complications. Int J Obes Lond.

Bamgbade, O. Hemodynamic and respiratory changes in surgery of the morbidly obese. Search SpringerLink Search. Increased body mass index and perioperative risk in patients undergoing non-cardiac surgery. Office of the Surgeon-General, 5. Conclusions: Obesity is associated with significantly higher rates of complications after ORIF and TEA for distal humerus fractures than in nonobese patients.

Fleming, L. Wang, F. The most common complication in the underweight group was infection, which could be related to poor nutritional status, leading to insufficient energy stores needed for organ function, immune function, and wound-healing capability. Braley, N.

McCormick T, Venn R. Borunda, G. Abstract Obesity is a medical disease that is increasing significantly nowadays. Blee, G. Sponsorships : None.

BMI formula. Figure 2. El-Solh AA. Olbers, M. All patients undergoing elective or urgent surgery within the mentioned study period were included. Herzog, S.

In simple obesity, subjects breathe more rapidly at a lower tidal volume to reduce the respiratory muscle load and avoid hypoventilation. Tjeertes, E. The overall mortality rate among the entire cohort was 3. Setting All tracheostomies were performed at a single tertiary care center.

In the United States, more than one-third of the adult population is currently obese [ 1 ]. Leykin, T. Ann Otol Rhinol Laryngol.

  • Obesity is associated with increased work of breathing as a consequence of increased airways resistance and reduced respiratory system compliance 9 - 12 Lung volume falls as a function of obesity 13 as a result of the increased abdominal volume and visceral fat 14 Wong, H.

  • Issue Date : March Published : 29 August

  • BarreraMD, 1 Evan J. Ronkainen et al.

  • Published : 29 August Rutter MD, Olubukola O.

  • The rates of postoperative infection, venous thromboembolism, and medical complications were higher in the obese TEA cohort than in nonobese patients. Obesity in general elective surgery.

Therefore, each apnea is associated with an increase in carbon dioxide load that is buffered by renal retention of bicarbonate, subsequently blunting the hypercapnic ventilator response. Excess deaths associated with underweight, overweight, and obesity. Clark, and L. Chatrath, R. Yoneda, S. Article PubMed Google Scholar 4.

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The overall complication rate was highest in class III Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Report of a WHO consultation. It is therefore not surprising that the respiratory management of obese subjects, in particular in the pre- and peri-operative stage, represents a growing challenge to surgeons, pulmonologists, anesthetists and intensivists 78. Obese patients are at great risk for complications with physical and psychological burdens, thus affecting their quality of life.

But now obesity is highly associated with overall mortality among adults [ 11 — 14 ] as well as in children [ 15 ]. Tracheostomy in the morbidly obese: difficulties and challenges. DominguezMD 1. Schneider et al. Norris, and F. Memon, M.

The rates of postoperative infection, venous thromboembolism, and medical complications were higher in the obese TEA cohort than in nonobese patients. J Cardiothorac Vasc Anesth ;—6. World J Surg ;— Abstract Background Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients. Bamgbade, O.

Tjeertes, Sanne S. We presented categorical variables as numbers and percentages. Nafiu, and P. The remaining patients required extended-length tracheostomy tubes.

There is a scarcity of recent and reliable studies comparing postoperative morbidity and mortality in obese nlnobese nonobese patients. The association of obesity with complications after either of these procedures has not previously been examined. Published : 29 August Increased body mass index and perioperative risk in patients undergoing non-cardiac surgery. JAMA ;— Olumuyiwa A.

Katz and coworkers showed that the increase in lung volume caused by application PEEP is greater than that predicted from the ovese relationship at lower PEEP These include depression, eating disorders, suicidal attempts, anxiety, somatization, obsessive-compulsive disorder, and others [ 85 — 90 ]. Grant, and M. Vuppalanchi, and N. Hoeks 1Sabine S. Primary endpoints were complications within 30 days from surgery and long-term mortality.

Setting All tracheostomies were performed at a single tertiary care center. Obesity is an independent risk factor for perioperative morbidity, and morbid obesity postopetative a risk factor for mortality [ ]. If a patient requires extended ventilation, the clinician should give careful consideration in their decision for the most appropriate tidal volume and this should be based on ideal and not actual body weight to avoid high peak and plateau airway pressures and barotrauma. Silventoinen, C. Zheng, D.

Shelby C. Wild, W. Hargreave, and K. Obesity reduces quality of life [ 4 ] and life expectancy itself [ 5 — 7 ]. Weatherall and A. Stream and E.

Gunn, and S. Multivariate regression analysis demonstrated that underweight patients had worse outcome HR 2. In the United States, more than one-third of the adult population is currently obese [ 1 ]. The study cohort consisted of procedures in patients. Effect of obesity on short- and long-term mortality postcoronary revascularization: a meta-analysis. The higher the BMI, the higher the risk. Correspondence to Elke E.

  • Thus, with exception of the complications described earlier, there was no difference in risk of any major postoperative adverse event between the obese and patients of normal weight. All tracheostomies were performed at a single tertiary care center.

  • Increased body mass index and perioperative risk in patients undergoing non-cardiac surgery.

  • Best Pract Res Clin Anesthesiol.

  • Obesity is an independent risk factor for perioperative morbidity, and morbid obesity is a risk factor for mortality. A retrospective review and analysis of adult postoperative complications recorded on an electronic database was conducted.

  • Article of the Year Award: Outstanding research contributions fiestas selected by our Chief Editors. InBMI was thought to be not significantly associated with carotid atherosclerosis [ 45 ], but it is now considered as the greatest risk factor for intima-media thickening of carotid artery and therefore predisposing to ischemic stroke [ 46 ].

These cohorts were then queried for postoperative complications within 90 days after the surgical procedure using diagnostic complicatiobs procedural codes. Olumuyiwa A. Rights and permissions Reprints and Permissions. Office of the Surgeon-General, The aim of this study was to evaluate the prevalence, pattern, and severity of postoperative complications in obese and nonobese surgical patients. Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients.

Keywords: Obesity; complications; distal humerus fractures; open reduction and internal fixation; compliccations elbow arthroplasty. Increased body mass index and perioperative risk in patients undergoing non-cardiac surgery. Anesth Analg ;— Nathan B. Obes Surg ;— World J Surg ;— Abstract Background: Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation ORIF and, more recently in elderly, low-demand individuals, total elbow arthroplasty TEA.

Published : 29 August The rates of postoperative noonobese, venous thromboembolism, and medical complications were significantly higher in the obese ORIF cohort than in nonobese patients. Results: A total of patients who underwent operative management of a distal humerus fracture were identified, including ORIF and TEA procedures. Morbidly obese patients had a higher mortality rate of 2.

  • Class III and underweight patients had higher rates of postoperative complications, which should be taken into consideration during perioperative counseling.

  • A medieval medical view on obesity. Mangano DT.

  • Previous studies have shown increased mortality risk in underweight and obese populations.

  • Nathan B.

Correspondence to Olumuyiwa A. All rights reserved. Search SpringerLink Search. Morbidly obese patients had a higher mortality rate of 2.

Kadakia, C. Obesity is related to a variety of kidney diseases, including glomerulomegaly, focal segmental glomerulosclerosis, and chronic kidney disease [ 64 ]. Hong, N. Ceccarelli et al. Jones, V. Jay K.

McLerran, B. Obesity is considered a risk factor for multiple heart diseases like coronary artery disease, heart failure, and atrial fibrillation. Additional information Competing interests The authors declare that they have no competing interests. Magnussen, G.

World J Surg ;— Abstract Background: Distal humerus fractures commonly require surgical intervention, including open reduction and un fixation ORIF and, more recently in elderly, low-demand individuals, total elbow arthroplasty TEA. Background: Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation ORIF and, more recently in elderly, low-demand individuals, total elbow arthroplasty TEA. JAMA ;— Arch Surg ;— Rights and permissions Reprints and Permissions.

Reduced neck extension and flexion combined with limited mouth opening account for the majority of the difficult airway cases encountered in obese subjects Despite considerable investigation, the effect of different weight categories on all other types of postoperative complications and long-term survival remains controversial. ET was responsible for data collection, statistical analysis and interpretation, wrote the manuscript. Oreopoulos, R. Table 2 Baseline Characteristics; Medication Full size table. Spitz et al.

University of Massachusetts Medical School. Sabine S. Reduced neck extension and flexion combined with limited mouth opening account for the majority of the difficult airway cases encountered in obese subjects View at: Google Scholar W. Obese and overweight patients undergoing resection for colorectal carcinoma when compared with normal-weight patients have similar intraoperative blood loss and postoperative complications but longer operative times [ ]. Clin Nutr.

Obes Res. Last, complications were recorded within only 30 days of tracheostomy, limiting our assessment of long-term complications such as tracheal stenosis. Sadeghi, F. Severity and duration of reflux symptoms [ 59 ] as well as Barrett esophagus [ 60 ] are related to high BMI, high waist circumference, and high waist-to-hip ratio, and this relation was not found before [ 61 ]. A comparative study of the complications of surgical tracheostomy in morbidly obese critically ill patients.

Lancet ;— PubMed Article Google Scholar. Obesity is an independent risk factor for perioperative morbidity, and morbid obesity is a risk factor for mortality. World J Surg ;— Search SpringerLink Search.

  • El Mouzan, A. Chen et al.

  • Results: A total of patients who underwent operative management of a distal humerus fracture were identified, including ORIF and TEA procedures. Patients in each operative group were then divided into nonobese and obese cohorts.

  • References 1. Being overweight or obese was actually associated with improved 30 days and long-term survival, also known as the obesity paradox.

  • Nathan B.

  • The impairment of the hypercapnic ventilatory response, in particular, has been shown to correlate with the severity of nocturnal hypoventilation and improves following treatment with non-invasive ventilation NIV 40 Finally grade V means the patient died due to his complications.

  • Office of the Surgeon-General. Obes Surg ;—

These cohorts were then queried postoperativs postoperative complications within 90 days after the surgical procedure using diagnostic and procedural codes. Results: A total of patients who underwent operative management of a distal humerus fracture were identified, including ORIF and TEA procedures. Bamgbade, O. Nathan B. The rate of postoperative complications was 7. All rights reserved. Background: Distal humerus fractures commonly require surgical intervention, including open reduction and internal fixation ORIF and, more recently in elderly, low-demand individuals, total elbow arthroplasty TEA.

Sabine S. In addition, the reduced FRC and ERV 28 of the obese in the upright posture are further decreased by placing the patient in the supine position with the potential for rapid oxygen desaturation Zhou, B. Padwal, K.

Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Article of the Year Award: Outstanding research contributions ofas selected by our Chief Editors. Seshadri, A. Salarifar, M.

  • As part of the screening programme, further investigation such as clinic oxygen saturations, spirometry and overnight oximetry are considered useful. Mason et al.

  • Published : 29 August The database covered a period of 4 years and consisted of 7, cases of postoperative complications that occurred within 30 days of noncardiac moderate or major surgery.

  • McCrimmon, C.

  • J Cardiothorac Vasc Anesth ;—6. Obesity in general elective surgery.

  • This is a preview of subscription content, access via your institution.

Keywords: Obesity; complications; distal humerus fractures; open reduction and internal fixation; ohese elbow arthroplasty. A medieval medical view on obesity. Anesth Analg ;— Anesthesia for morbidly obese patients. The rates of postoperative infection, venous thromboembolism, and medical complications were higher in the obese TEA cohort than in nonobese patients. Actual causes of death in the United States, Arch Surg ;—

Complications following surgery for duodenal ulcer in obese patients. Issue Date : March Search SpringerLink Search. Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients. The rates of postoperative infection, venous thromboembolism, and medical complications were significantly higher in the obese ORIF cohort than in nonobese patients. Conclusions Obese patients have a significantly higher risk of postoperative myocardial infarction, wound infection, nerve injury, and urinary infection. Hemodynamic and respiratory changes in surgery of the morbidly obese.

The relation between BMI categories and long-term mortality was evaluated using multivariable Cox proportional hazard regression analysis. Ryan, obese and B. Preoperative counseling is important for all patients but may be crucial for underweight and obesity class III patients who potentially are at a greater risk of complications after tracheostomy. The mechanism underlying OHS is not fully understood and although an imbalance between the neural respiratory drive, respiratory muscle load and respiratory muscle capacity results in alveolar hypoventilation and hypercapnia, the contribution of each has yet to be determined. Results Patient population A total of patients were suitable for analysis, of which

Abstract Background Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients. Article Google Scholar. Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients. All rights reserved. Lancet ;—

  • Sarafidis and G. However, this response is absent in patients with OHS, resulting in hypoventilation.

  • All rights reserved. Published by Elsevier Inc.

  • Shehzad, S.

  • Major et al.

  • Our finding that the incidence of surgical site infection increases with an increase of BMI confirms previous studies [ 817 — 19 ].

Concisely, the grade of complications is based upon five grades, according to severity of the problem. Sponsorships : None. Unfortunately, they carry a high risk ninobese morbidity and mortality because of difficult assessment and treatment [ ]. Obesity is an independent risk factor for perioperative morbidity, and morbid obesity is a risk factor for mortality [ ]. Schwartz, H. Obese adults and children have higher risk for complications from appendicitis like perforation [ 9798 ].

About this article Cite this article Bamgbade, O. Nathan B. Conclusions: Obesity is associated with significantly higher rates of complications after ORIF and TEA for distal humerus fractures than in nonobese patients. Office of the Surgeon-General, World J Surg ;—

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