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January 22, 2021World Journal of Surgery

Higher BMI linked to lower 30-day mortality in surgical patients with and without diabetes.

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Why the study?

While obesity is typically linked to increased morbidity and mortality, chronic disease populations often exhibit an obesity paradox, prompting investigation into the relationship between BMI, mortality, and length of hospital stay in general surgical patients.

Does higher BMI reduce mortality in patients hospitalized to general surgical wards?

Population

27,639 patients hospitalized to general surgical wards

Comparison

Underweight vs normal weight vs overweight vs obesity vs severe obesity

Design

Retrospective cohort study

Key result

Higher body mass index was inversely associated with 30-day mortality in surgical patients with diabetes (10% for underweight, 6% for normal weight, 1% for severely obese) and without diabetes.

Authors

IDIdit DotanISIlan ShimonAAAmit Akirov

Discussion

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Member takes

Overview

Should not yet change BMI-based perioperative risk assessment; supports obesity paradox in surgical patients but remains hypothesis-generating.

Study Design

Type

Cohort (n=27,639)

Structured PICO

Does higher BMI reduce mortality in patients hospitalized to general surgical wards?

P
Population
27,639 patients (mean age 55 years, 52% female, 19% with diabetes) hospitalized to general surgical wards between 2011 and 2017.
E
Exposure
Higher BMI categories (overweight, obesity, severe obesity)
C
Comparator
Normal weight (BMI 18.5-24.9) or lower BMI categories
O
Outcome
30-day mortality and end-of-follow-up mortalityhard clinical

Main Result

Odds Ratio: 1.3 (95% CI 1.2–1.5)

Higher BMI is associated with lower short- and long-term mortality in general surgical patients, supporting the 'obesity paradox'.

Cite This Study

Dotan et al. (2021) conducted a cohort in General surgical patients (n=27,639). Body mass index (BMI) vs. Normal weight (18.5-24.9) was evaluated on 30-day mortality, end-of-follow-up mortality, and length of hospital stay (OR 1.3, 95% CI 1.2-1.5). Higher body mass index was inversely associated with 30-day mortality in surgical patients with diabetes (10% for underweight, 6% for normal weight, 1% for severely obese) and without diabetes.

synapsesocial.com/papers/6aaa62aa598f2e104f57c5f3https://doi.org/10.1007/s00268-021-05961-4
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Body mass index and mortality in patients with and without diabetes mellitus2017 · 3 citations
  2. 2The Obesity Paradox2009 · 607 citations
  3. 3The Relationship Between Body Mass Index and 30-Day Mortality Risk, by Principal Surgical Procedure2011 · 31 citations
  4. 4Obesity is associated with lower 30-day mortality in critically ill patients: A retrospective study of over 5400 patients2025 · 2 citations
  5. 5The Effect of Body Mass Index on Perioperative Outcomes After Major Surgery: Results from the National Surgical Quality Improvement Program (ACS‐NSQIP) 2005–20112015 · 97 citations