title: Obesity is Associated With Poor Surgical Outcome in Crohn's Disease.
abstract: BACKGROUND
  Published data suggest a link between obesity and adverse outcomes in Crohn's disease (CD). We aimed to test the hypothesis that obese CD patients would be more likely than non-obese CD patients to have poor surgical outcome when undergoing surgery for a complication of CD.
  
  
  METHODS
  We designed a retrospective cohort study to test our hypothesis. The population comprised of adult CD patients who underwent CD related surgery at a tertiary referral center. The exposed and unexposed cohorts were represented by patients who were obese vs. non-obese at the pre-op visit respectively. Outcome was represented by successful vs. unsuccessful surgical outcome as deemed by the treating clinician.
  
  
  RESULTS
  Ninety CD patients were eligible for inclusion into this cohort study of which 36 were obese (exposed cohort) and 54 were non-obese (unexposed cohort). Among obese CD patients, 64% had an unsuccessful surgical outcome vs. 41% with unsuccessful surgical outcome among the non-obese. Based on unadjusted bivariate analysis, potential confounders identified included age and type of surgery. Gender distribution, disease duration, ethnicity, tobacco use, steroid use, traditional and biological immune modulator use and clinical disease activity were similar between the two groups. Logistic regression adjusted for age and type of surgery revealed that obese CD patients were approximately 2.5 times more likely to have a poor surgical outcome than patients with CD who were not obese (P = 0.05 OR 2.53 95% CI 0.99 - 6.52). BMI as a continuous variable (adjusted for age and type of surgery) appeared to be associated with poor surgical outcome (P = 0.06 OR 1.07 95% CI 0.99 - 1.15).
  
  
  CONCLUSIONS
  Obesity may be associated with poor surgical outcome in CD patients.
authors: Division of Gastroenterology/Hepatology, Department of Medicine, University of Alabama at Birmingham, USA.
authors: Talha A
authors: TA
authors: Malik
authors: Division of Gastroenterology/Hepatology, Department of Medicine, University of Alabama at Birmingham, USA.
authors: Ashish
authors: A
authors: Manne
authors: Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, USA.
authors: Robert A
authors: RA
authors: Oster
authors: Division of Gastroenterology/Hepatology, Department of Medicine, University of Alabama at Birmingham, USA.
authors: Austin
authors: A
authors: Eckhoff
authors: Department of Biostatistics, University of Alabama at Birmingham, USA.
authors: Seidu
authors: S
authors: Inusah
authors: Division of Gastroenterology/Hepatology, Department of Medicine, Washington University in Saint Louis, USA.
authors: Alexandra M
authors: AM
authors: Gutierrez
keywords: Body mass index; Crohn’s disease; Obesity; Surgery