The modified metabolic syndrome in patients undergoing noncardiac surgery was associated with a higher risk of 30-day mortality (AOR 1.99 for super obese) compared with normal-weight patients.
Observational (n=310,208)
Yes
Does the modified metabolic syndrome increase the risk of 30-day mortality and complications in patients undergoing noncardiac surgery?
Patients with modified metabolic syndrome undergoing noncardiac surgery have a substantially higher risk of 30-day mortality, cardiac adverse events, and acute kidney injury compared to normal-weight patients, challenging the obesity paradox in this specific subgroup.
Effect estimate: AOR 1.99 (95% CI 1.41-2.80)
BACKGROUND: Previous studies have demonstrated that obesity is paradoxically associated with a lower risk of mortality after noncardiac surgery. This study will determine the impact of the modified metabolic syndrome (defined as the presence of obesity, hypertension, and diabetes) on perioperative outcomes. METHODS: This study is based on data from 310,208 patients in the American College of Surgeons National Surgical Quality Improvement Program database. We estimated separate multivariate logistic regression models for 30-day mortality and for 30-day complications. RESULTS: Patients with the modified metabolic syndrome who are super obese had a 2-fold increased risk of death (adjusted odds ratio AOR 1.99; 95% CI 1.41-2.80). As stratified by body mass index, patients with the modified metabolic syndrome had a 2- to 2.5-fold higher risk of cardiac adverse events (CAE) compared with normal-weight patients: obese (AOR 1.70; 95% CI 1.40-2.07), morbidly obese (AOR 2.01; 95% CI 1.48-2.73), and super obese (AOR 2.66; 95% CI 1.68-4.19). In addition, the risk of acute kidney injury (AKI) was 3- to 7-fold higher in these patients: obese (AOR 3.30; 95% CI 2.75-3.94), morbidly obese (AOR 5.01; 95% CI 3.87-6.49), and super obese (AOR 7.29; 95% CI 5.27-10.1). CONCLUSION: Patients with the modified metabolic syndrome undergoing noncardiac surgery are at substantially higher risk of complications compared with patients of normal weight.
Glance et al. (Tue,) conducted a observational in Modified metabolic syndrome in noncardiac surgery (n=310,208). Modified metabolic syndrome vs. Normal-weight patients was evaluated on 30-day mortality (AOR 1.99, 95% CI 1.41-2.80). The modified metabolic syndrome in patients undergoing noncardiac surgery was associated with a higher risk of 30-day mortality (AOR 1.99 for super obese) compared with normal-weight patients.