The Effect of Obesity on Postoperative Complications of Abdominal Surgery on Adults in 3 Public Hospitals of Cameroon
Benjamin Momo KADIA; Ekane Edie Gregory HALLE ;Elroy Patrick WELEDJI ; Alain Mefire CHICHOM
CaHReF 20116, Yaoundé Conges hall, 23 – 26 August 2016 , PL099
There are controversial reports on the effect of obesity on postoperative complications (POCs) of abdominal surgery (AS), still widely performed as open surgery in Africa. With scarce data describing POCs of AS on obese patients in Cameroon, we sought to find out: is there a significant difference in the rates and types of POCs in obese and non-obese patients? What are the types and determinants of POCs in obese patients?
To determine if there is an association between obesity and POCs of AS
We conducted a prospective study at Buea and Limbe regional hospitals and Kumba district hospital from November 2014 to March 2015. Obese (BMI ≥25kg/m2) and non-obese (BMI<25 kg/m2) adult patients were matched for level of health care, gender, age (±5years) and type/status of surgery. Other demographic and operative variables were recorded. POCs were reported as per Clavien-Dindo classification and further characterized by their temporal patterns/sites. Data was analysed using Epi-Info 7 statistical software.
We enrolled 206 participants; 103 per group. The demographic and operative variables were not significantly different between the groups. The rates of POCs were not significantly different between obese and non-obese participants (12.6% versus 19.4%; p=0.127). Also, the severity, temporal patterns/sites of POCs did not significantly differ between both groups. POCs in obese participants were 53.9% (95% C.I: 25.13-80.78) Grade II, 38.5% (95 % C.I: 13.86-68.42) Grade I, and 7.1% (95% C.I: 0.19-36.03) Grade III. These were, otherwise, 61.5% (95% C.I: 31.6-86.1) early systemic, 30.8% (95% C.I: 9.1- 69.4) early wound and 7.7% (95% C.I: 0.2-36.0) late wound complications. Determinants of POCs in obese participants were district hospital (p=0.033), older age (p=0.016), increasing BMI (p=0.0086) and perioperative transfusion (p=0.038).
In-hospital POCs of AS on obese patients were mostly minor. Obesity seems to influence POCs in a BMI-dependent manner. We advocate for optimal surgical care for the obese.
Obesity, Postoperative complications, Adult, Abdominal surgery.