The influence of BMI on perioperative morbidity following abdominal hysterectomy

Objective: The objective of the study was to assess the impact of body mass index (BMI) on 30 day perioperative morbidity following abdominal hysterectomy. Study Design: The 2006-2010 National Surgical Quality Improvement Program data registry was retrospectively reviewed for patients undergoing abdominal hysterectomy. Logistic regression was used to investigate the relationship between BMI and postoperative complications. Results: A total of 9917 patients were captured, of which, 2219 were of an ideal BMI, 2765 were overweight, and 4933 were obese. Complications occurred in 11.3% of the procedures, with obese patients experiencing significantly higher rates of morbidity compared with overweight and nonobese patients (13.2%, 9.7%, and 9.0%, respectively; P <.001). Surgical complications were rare; however, a significant step-wise progression was observed with increasing BMI (P <.001). The rate of reoperations and overall medical complication did not differ among cohorts, although the incidence of deep vein thromboses (DVTs) was notably elevated in obese and overweight patients (P =.032). Adjusted odds ratios (ORs) found both overweight and obese patients to be at a significantly higher risk of surgical complications (OR, 1.6 and 3.0, respectively) and wound infections (OR, 1.7 and 3.0, respectively). Overweight patients were also at higher risk for DVTs (OR, 4.6) and obese patients for overall morbidity (OR, 1.4) and wound disruption (OR, 3.6). Conclusion: Obese and overweight patients demonstrated an increased risk for periorperative morbidity following abdominal hysterectomies.