title: Simple measurement of intra-abdominal fat for abdominal surgery outcome prediction.
abstract: OBJECTIVE
  To assess the effect of increasing body mass index, intra-abdominal fat, and outer abdominal fat on outcome in patients undergoing major hepatectomy.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Memorial Sloan-Kettering Cancer Center.
  
  
  METHODS
  We studied patients aged 19 to 86 years undergoing major hepatic resection between June 18, 1996, and November 6, 2001. Complications were extracted from a prospective database at a tertiary cancer center.
  
  
  METHODS
  A total of 349 patients were grouped according to body mass index for analysis. Preoperative abdominal computed tomographic scans were examined and measurements of perinephric fat (as a surrogate for intra-abdominal fat) and outer abdominal fat taken at uniform anatomical locations.
  
  
  METHODS
  We compared 30-day mortality and morbidity figures, length of stay, and operating times.
  
  
  RESULTS
  Body mass index had an influence on operative time (P = .02) but no significant effect on mortality, frequency of any complications, frequency of severe complications, or length of stay (P = .80, P = .89, P = .16, and P = .81, respectively). Outer abdominal fat had no significant effect on any of the 5 outcome measures. Perinephric fat measurements had a significant effect on most outcome measures (P = .004 for mortality, P = .003 for frequence of complications, P < .001 for frequence of severe complications, and P = .001 for length of stay).
  
  
  CONCLUSIONS
  Outer appearances of obesity do not correlate with poor outcomes for major upper abdominal operations. A simple measurement of perinephric fat, as a surrogate for intra-abdominal fat, on preoperative imaging gives a more useful risk assessment for patients undergoing major upper abdominal operations.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Morris
authors.forename: Scott
authors.initials: S
authors.lastname: Tuorto
authors.forename: Mithat
authors.initials: M
authors.lastname: Gönen
authors.forename: Lawrence
authors.initials: L
authors.lastname: Schwartz
authors.forename: Ronald
authors.initials: R
authors.lastname: DeMatteo
authors.forename: Michael
authors.initials: M
authors.lastname: D'Angelica
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D011183:Postoperative Complications / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed