Underweight patients are at a higher risk of mortality after
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Elevated body mass index is a risk factor for gallstone disease and cholecystectomy, but outcomes for low body mass index patients suggest that low body weight is associated with increased risk of mortality and readmission after cholecystectomy.

Doctors examined the association of body mass index with morbidity, mortality, and resource use after cholecystectomy. The study was published in the Surgery.

The 2005 to 2016 American College of Surgeons National Surgical Quality Improvement Program was retrospectively analyzed for adult patients undergoing laparoscopic and open cholecystectomy. Patients were stratified into 5 groups: body mass index <18.5 (underweight), body mass index 18.5 to 24.9 (normal weight), body mass index 25 to 29.9 (overweight), body mass index 30 to 34.9 (class I obesity), body mass index 35 to 39.9 (class II obesity), and body mass index ?40 (class III obesity).

Of 327,473 cholecystectomy patients, 1.0% were underweight, 19.5% normal weight, 30.3% overweight, 24.0% class I obesity, 13.5% class II obesity, and 11.7% class III obesity.

--After multivariable analysis, underweight patients had a higher risk of mortality and postoperative bleeding relative to normal-weight patients.

--Conversely, class III obesity patients had lower mortality but increased operative time, wound infection, and wound dehiscence.

--Hospital duration of stay and readmission rates were highest for underweight patients.

Conclusively, underweight patients experience an increased risk of mortality and readmission, while class III obesity patients have higher rates of wound infection and dehiscence as well as prolonged operative time. These findings may guide the choice of intervention.

Source: https://doi.org/10.1016/j.surg.2021.03.034
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