BACKGROUND Overweight and obese patients undergoing pancreatectomy are at increased risk for postoperative complications and readmission. We examined the association between body mass index (BMI) and postoperative complications following major pancreatectomy using the novel Comprehensive Complications Index (CCI), which analyzes the impact of multiple surgical complications rather than just the most severe. METHODS We performed a retrospective dual institutional international review of 500 consecutive patients who underwent pancreatic resection and assessed the association of BMI with postoperative complications using the CCI and Clavien-Dindo Classification (CDC) with uni- and multivariable analyses. RESULTS Overweight and obese patients undergoing pancreatic resection demonstrated a higher incidence and severity of CCI-measured complications (29.3 vs. 21.1, P < 0.001), more pancreatic fistulae (15.4 vs. 8.8%, 95% CI 1.005 -1.902), and an increased 30-day readmission rate (21.1 vs. 12.1%, 95% CI 1.067 -1.852) (all p < 0.05) than normal-BMI patients. The CCI was a more sensitive marker of post-pancreatectomy complications relative to the CDC, with a higher multicomplication rate in overweight/obese patients (54.8% vs. 44.5%). CONCLUSION Patients with overweight and obese body mass index undergoing major pancreatectomy demonstrated higher rates of postoperative complications, pancreatic fistulae, and readmissions. The CCI is a more robust and sensitive tool to assess post-pancreatectomy complications than the CDC.

中文翻译：

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胰腺切除术和体重指数：使用综合并发症指数对术后累积累积并发症的国际评价。

背景技术进行胰腺切除术的超重和肥胖患者术后并发症和再次入院的风险增加。我们使用新颖的综合并发症指数（CCI）检查了大胰腺切除术后的体重指数（BMI）与术后并发症之间的关联，该指数分析了多种外科手术并发症的影响，而不仅仅是最严重的并发症。方法我们对500例行胰腺切除术的连续患者进行了回顾性双机构国际回顾，并使用CCI和Clavien-Dindo分类（CDC）进行了单变量和多变量分析，评估了BMI与术后并发症的相关性。结果进行胰腺切除的超重和肥胖患者表现出较高的CCI测量并发症发生率和严重程度（29.3 vs. 21.1，P <0.001），更多的胰瘘（15.4 vs. 8.8％，95％CI 1.005 -1.902），以及与正常BMI患者相比，增加了30天的再入院率（21.1比12.1％，95％CI 1.067 -1.852）（所有p <0.05）。与CDC相比，CCI是胰腺切除术后并发症的更敏感标志，超重/肥胖患者的多重并发症发生率更高（54.8％对44.5％）。结论接受大型胰腺切除术的超重和肥胖体重指数患者表现出较高的术后并发症，胰瘘和再入院率。与CDC相比，CCI是评估胰腺切除术后并发症的更强大，更敏感的工具。001），更多的胰瘘（15.4 vs. 8.8％，95％CI 1.005 -1.902）和增加的30天再入院率（21.1 vs. 12.1％，95％CI 1.067 -1.852）（均p <0.05）正常BMI患者。与CDC相比，CCI是胰腺切除术后并发症的更敏感标志，超重/肥胖患者的多重并发症发生率更高（54.8％对44.5％）。结论接受大型胰腺切除术的超重和肥胖体重指数患者表现出较高的术后并发症，胰瘘和再入院率。与CDC相比，CCI是评估胰腺切除术后并发症的更强大，更敏感的工具。001），更多的胰瘘（15.4 vs. 8.8％，95％CI 1.005 -1.902）和增加的30天再入院率（21.1 vs. 12.1％，95％CI 1.067 -1.852）（均p <0.05）正常BMI患者。与CDC相比，CCI是胰腺切除术后并发症的更敏感标志，超重/肥胖患者的多重并发症发生率更高（54.8％对44.5％）。结论接受大型胰腺切除术的超重和肥胖体重指数患者表现出较高的术后并发症，胰瘘和再入院率。与CDC相比，CCI是评估胰腺切除术后并发症的更强大，更敏感的工具。与CDC相比，CCI是胰腺切除术后并发症的更敏感标志，超重/肥胖患者的多重并发症发生率更高（54.8％对44.5％）。结论接受大型胰腺切除术的超重和肥胖体重指数患者表现出较高的术后并发症，胰瘘和再入院率。与CDC相比，CCI是评估胰腺切除术后并发症的更强大，更敏感的工具。与CDC相比，CCI是胰腺切除术后并发症的更敏感标志，超重/肥胖患者的多重并发症发生率更高（54.8％对44.5％）。结论接受大型胰腺切除术的超重和肥胖体重指数患者表现出较高的术后并发症，胰瘘和再入院率。与CDC相比，CCI是评估胰腺切除术后并发症的更强大，更敏感的工具。