title: Obesity is a predictor of morbidity in 1,629 patients who underwent adrenalectomy.
abstract: BACKGROUND
  We examined the impact of obesity on 30-day outcomes of adrenalectomy using a multi-institutional database.
  
  
  METHODS
  Patients who underwent adrenalectomy in 2005-2008 according to the American College of Surgeons-National Surgical Quality Improvement Project (ACS-NSQIP) data set were grouped by body mass index (BMI): normal weight (BMI=18.5-24.9 kg/m2), overweight (BMI=25.0-29.9 kg/m2), obese (BMI=30.0-34.9 kg/m2), and morbidly obese (BMI≥35 kg/m2). Outcomes of the higher BMI groups were compared to those of the normal BMI group using χ2, analysis of variance (ANOVA), and multivariate regression.
  
  
  RESULTS
  There were 1,629 patients in the study: 22% were normal weight, 31% overweight, 22.2% obese, and 24.7% morbidly obese. Compared to normal-weight patients, obese and morbidly obese patients had a 12.5 and 16.7% increase in operation times (129 vs. 145 and 150 min, respectively, p≤0.01) and sustained more wound complications (0.2 vs. 0.4 and 1.2%, p<0.001), including superficial and deep wound infections (p<0.001 and p<0.01, respectively). Morbid obesity independently predicted overall complications (odds ratio [OR] 2.9, 95% confidence interval [CI]: 1.7-5.7), wound complications (OR 6.1, 95% CI: 2.0-18.9), and septic complications (OR 3.1, 95% CI: 1.1-8.8). Obesity independently predicted longer total time in the operating room (p<0.006). There were no differences in rates of reoperation and length of hospital stay by BMI category.
  
  
  CONCLUSIONS
  Obesity is an independent risk factor that needs to be considered in surgical decisions regarding adrenalectomy. Morbidly obese adrenalectomy patients are particularly at risk for wound and septic complications.
authors: Yale University School of Medicine, 330 Cedar St., Tompkins 208, P.O. Box 208062, New Haven, CT 06520, USA.
authors: Hadiza S
authors: HS
authors: Kazaure
authors: Sanziana A
authors: SA
authors: Roman
authors: Julie A
authors: JA
authors: Sosa
mesh_terms: D000315:Adrenalectomy / Q000009:adverse effects* / Q000379:methods; D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D009767:Obesity, Morbid / Q000150:complications / Q000175:diagnosis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States