title: Impact of body mass index on complications following pancreatectomy: Ten-year experience at National Cancer Center in China.
abstract: OBJECTIVE
  To examine the impact of body mass index (BMI) on outcomes following pancreatic resection in the Chinese population.
  
  
  METHODS
  A retrospective cohort study using prospectively collected data was conducted at the Cancer Hospital of the Chinese Academy of Medical Sciences, China National Cancer Center. Individuals who underwent pancreatic resection between January 2004 and December 2013 were identified and included in the study. Persons were classified as having a normal weight if their BMI was < 24 kg/m(2) and overweight/obese if their BMI was ≥ 24 kg/m(2) as defined by the International Life Sciences Institute Focal Point in China. A χ(2) test (for categorical variables) or a t test (for continuous variables) was used to examine the differences in patients' characteristics between normal weight and overweight/obese groups. Multiple logistic regression models were used to assess the associations of postoperative complications, operative difficulty, length of hospital stay, and cost with BMI, adjusting for age, sex, and type of surgery procedures.
  
  
  RESULTS
  A total of 362 consecutive patients with data available for BMI calculation underwent pancreatic resection for benign or malignant disease from January 1, 2004 to December 31, 2013. Of the 362 patients, 156 were overweight or obese and 206 were of normal weight. One or more postoperative complications occurred in 35.4% of the patients following pancreatic resection. Among patients who were overweight or obese, 42.9% experienced one or more complications, significantly higher than normal weight (29.6%) individuals (P = 0.0086). Compared with individuals who had normal weight, those with a BMI ≥ 24.0 kg/m(2) had higher delayed gastric emptying (19.9% vs 5.8%, P < 0.0001) and bile leak (7.7% vs 1.9%, P = 0.0068). There were no significant differences seen in pancreatic fistula, gastrointestinal hemorrhage, reoperation, readmission, or other complications. BMI did not show a significant association with intraoperative blood loss, operative time, length of hospital stay, or cost.
  
  
  CONCLUSIONS
  Higher BMI increases the risk for postoperative complications after pancreatectomy in the Chinese population. The findings require replication in future studies with larger sample sizes.
authors.affiliation: Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China.
authors.forename: Ying-Tai
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Deng
authors.affiliation: Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Che
authors.affiliation: Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China.
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Zhang
authors.affiliation: Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China.
authors.forename: Yu-Heng
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China.
authors.forename: Dong-Bin
authors.initials: DB
authors.lastname: Zhao
authors.affiliation: Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China.
authors.forename: Yan-Tao
authors.initials: YT
authors.lastname: Tian
authors.affiliation: Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China.
authors.forename: Ya-Wei
authors.initials: YW
authors.lastname: Zhang
authors.affiliation: Ying-Tai Chen, Xu Che, Jian-Wei Zhang, Yu-Heng Chen, Dong-Bin Zhao, Yan-Tao Tian, Cheng-Feng Wang, Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China National Cancer Center, Beijing 100021, China.
authors.forename: Cheng-Feng
authors.initials: CF
authors.lastname: Wang
mesh_terms: D000368:Aged; D044466:Asian People; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002681:China; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D010180:Pancreatectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000208:ethnology / Q000209:etiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Body mass index; China; Pancreatectomy; Pancreatic cancer; Postoperative complications