Use of the abdominal wall fat index determined ultrasonographically for assessing the risk of post-operative pulmonary embolism.
OBJECTIVE
To assess the usefulness of the abdominal wall fat index (AFI) for predicting pulmonary embolism (PE) after gynecologic surgery.


METHODS
The subjects were 115 female patients who underwent laparotomy for gynecologic disease. They were divided into low-dose heparin therapy (n=28) and control, without heparin (n=87) groups. The AFI ratio of the maximum preperitoneal fat thickness to the minimum subcutaneous fat thickness was determined using ultrasonography.


RESULTS
Post-operative PE occurred in four control patients. If the cut-off value of the AFI for predicting PE development was set at more than or equal to 0.85, the sensitivity was 1.00 and the specificity was 0.60 (P=0.03). If we restricted the criteria, and set the cut-off value of the AFI to more than or equal to 0.85 in patients with hypertension [systolic blood pressure (BP)>/=140 mmHg, diastolic BP>/=90 mmHg or patients were taking antihypertensive medication], the sensitivity and specificity were 0. 75 and 0.92, respectively (P=0.001).


CONCLUSIONS
Visceral fat obesity is a risk factor for PE after gynecologic surgery, and the AFI is useful for predicting PE and for whom post-operative low-dose heparin therapy may be indicated.
Nishikawa
N
N
Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan.
Kurabayashi
T
T
Tomita
M
M
Matsushita
H
H
Aoki
Y
Y
Tanaka
K
K
D000005:Abdomen / Q000000981:diagnostic imaging; D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006400:Hematocrit; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000209:etiology*; D018570:Risk Assessment / Q000379:methods; D014463:Ultrasonography