title: Obesity is Not an Independent Factor for Adverse Outcome after Abdominal Aortic Aneurysm Repair.
abstract: BACKGROUND
  The prevalence of obesity is increasing, and its impact on the outcome of open and endovascular abdominal aortic aneurysm (AAA) repair remains unclear, particularly in the European population. We herein assessed the impact of obesity on the postoperative course for both techniques.
  
  
  METHODS
  From a database that consecutively collects all patients undergoing AAA repair; we selected all patients undergoing elective surgery for open or endovascular AAA repair, between January 2003 and December 2011. We considered obese patients (body mass index >30 kg/m(2)), overweight (25.1-30 kg/m(2)), and normal-weight patients (18.7-25 kg/m(2)), and compared mortality and/or severe complications at 30 days between obese and nonobese patients (overweight and normal weight) separately for each type of surgery by logistic regression analysis. We analyzed wound complications in the 2 groups.
  
  
  RESULTS
  We included 748 patients, 174 obese, and 574 nonobese patients. Obese patients were younger (P < 0.001) and were less likely to have renal failure (P < 0.001) in both techniques. Obese patients in the open repair (OR) group showed a trend toward lower mortality and/or complication rates than in nonobese patients (4.8% vs. 7.5%, P = 0.34). In contrast, in the endovascular aortic aneurysm repair (EVAR) group, obese patients showed a trend toward higher mortality and/or complication rates than nonobese patients (7.1% vs. 3.2%, P = 0.17). In multivariate analysis, obesity was not an independent predictor of outcomes in OR (P = 0.18) or in EVAR (P = 0.20). Wound complications were not higher in obese patients in OR and in EVAR.
  
  
  CONCLUSIONS
  Obesity should not be considered an independent risk factor of death and severe complications at 30 days in either open or endovascular AAA repair. Therefore, obesity should not systematically lead to the decision to use EVAR.
authors.affiliation: Service de chirurgie vasculaire, CHRU Besançon, Besançon, France; Université de Franche-Comté, unité de recherche UMR 6249 "Chrono-environnement", Besançon, France. Electronic address: lsalomondumont@chu-besancon.fr.
authors.forename: Lucie
authors.initials: L
authors.lastname: Salomon du Mont
authors.affiliation: Université de Franche-Comté, unité de recherche UMR 6249 "Chrono-environnement", Besançon, France; Centre de méthodologie Clinique, CHRU de BESANCON, Besançon, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Mauny
authors.affiliation: Service de chirurgie cardio-vasculaire et thoracique, CHU Le Bocage, Dijon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Chrétien
authors.affiliation: Service de chirurgie cardio-vasculaire et thoracique, CHU Le Bocage, Dijon, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Kazandjan
authors.affiliation: Service de chirurgie cardio-vasculaire et thoracique, CHU Le Bocage, Dijon, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Bourgeot
authors.affiliation: Service de chirurgie cardio-vasculaire et thoracique, CHU Le Bocage, Dijon, France.
authors.forename: Valentin
authors.initials: V
authors.lastname: Crespy
authors.affiliation: Direction de la recherche clinique et de l'innovation, CHU Le Bocage, Dijon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Abello
authors.affiliation: Service de chirurgie vasculaire, CHRU Besançon, Besançon, France; Université de Franche-Comté, EA4268 INSERM, Besançon, France.
authors.forename: Simon
authors.initials: S
authors.lastname: Rinckenbach
authors.affiliation: Service de chirurgie cardio-vasculaire et thoracique, CHU Le Bocage, Dijon, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Steinmetz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D015992:Body Mass Index; D016208:Databases, Factual; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D018579:Patient Selection; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000401:mortality