title: The Impact of Obesity on the 30-day Morbidity and Mortality After Surgery for Ovarian Cancer.
abstract: OBJECTIVE
  To examine the effect of body mass index (BMI) on postoperative 30-day morbidity and mortality after surgery for ovarian cancer (OC).
  
  
  METHODS
  Patients with OC were identified from the American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2011. Women were divided into 3 groups: nonobese (BMI <30 kg/m), obese (30 to <40 kg/m), and morbidly obese (≥40 kg/m). Multivariable logistic regression models were performed.
  
  
  RESULTS
  Of 2061 women included in this study, 1336 (65%) were nonobese, 560 (27%) were obese, and 165 (8%) were morbidly obese. The overall 30-day mortality and morbidity rates for the entire cohort were 2% and 31%, respectively. In multivariate analyses adjusting for confounders, both obese (odds ratio [OR], 0.9; 95% confidence interval [CI], 0.4-2.0; P = 0.87) and morbid obesity (OR, 0.8; 95% CI, 0.1-3.0; P = 0.73) were not significant predictors of increased 30-day postoperative mortality. Likewise, rates of any complication in 30 days were comparable between nonobese, obese, and morbidly obese patients (31% vs. 28% vs. 33%, respectively; P = 0.35) with no significant difference even after adjusting for other confounders (OR, 0.9; 95% CI, 0.7-1.1; P = 0.26 and OR, 1.1; 95% CI, 0.7-1.6; P = 0.70, respectively). Obese and morbidly obese patients were more likely to have diabetes, hypertension requiring medications, cardiac morbidities, higher American Society of Anesthesiologists class, and leukocytosis and less likely to have weight loss before surgery.
  
  
  CONCLUSIONS
  With appropriate control for confounding comorbidities, the 30-day morbidity and mortality rates for the obese and morbidly obese patients undergoing surgery for OC do not seem to differ. Therefore, reported inferior long-term survival for these patients is likely related to a different phase of their disease and treatment process and is deserving of further investigation.
authors.affiliation: *Gynecologic Oncology Division, Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH; †Red Crescent Clinic of Tampa Bay, Tampa, FL; ‡Department of Biostatistics, University of Washington, Seattle, WA; and §University of Kufa School of Medicine, Najaf, Iraq.
authors.forename: Haider
authors.initials: H
authors.lastname: Mahdi
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Alhassani
authors.forename: David
authors.initials: D
authors.lastname: Lockhart
authors.forename: Hussain
authors.initials: H
authors.lastname: Al-Fatlawi
authors.forename: Andrew
authors.initials: A
authors.lastname: Wiechert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010051:Ovarian Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult