2010 Annual Meeting Abstracts
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Obesity is an Independent risk factor for Post-Operative Renal Dysfunction: A Review of the ACS-NSQIP database
*Gezzer Ortega1, *Oluwaseyi B Bolorunduro1, *Maricel Cubangbang1, *Richard Alexander1, *Clive O Callendar, Jr.1, *Patricia L Turner2, Wayne A Frederick1, Terrence M Fullum1
1Howard University College of Medicine, Washington, DC;2University of Maryland, Baltimore, MD
Objective: This study examines the association between Body Mass Index (BMI) and post-operative renal function in surgical patients in a national database.
Design: A retrospective analysis of the ACS-NSQIP dataset.
Setting: National Surgical Quality Improvement Project (ACS-NSQIP) 2005-2007.
Patients: Patients 18-35 years old with a BMI >= 18 kg/m2 were included in the study. 36,493 patients met inclusion criteria.
Main Outcome Measures: Post-operative renal failure and renal insufficiency. Using the Modified Diet for Renal Disease (MDRD) formula, estimated GFR (eGFR) was calculated from creatinine values. Multiple linear regression for pre-operative eGFR and logistic regression for post-operative renal failure and renal insufficiency were performed adjusting for standard BMI categories, demographics, presence of hypertension, diabetes, cardiac, pulmonary co-morbidities, and smoking status.
Results: eGFR was similar in all BMI categories. Median GFR was 103(IQR 88-122) in the reference category (BMI= 18-29) and was104(IQR 89-123) among patients with BMI >=50. On multivariate analysis, expected GFR in patients with BMI>=50 was 4 units higher than that of patients with BMI between18-29 (RR =3.99 P<0.001). Patients with a BMI between 40 and 50 and those with BMI >50 were more likely to develop post-operative renal insufficiency than the reference group (OR=3.39, P=0.019 and OR=7.66, P<0.001 respectively). There was a trend towards increased odds of developing post-op renal failure among patients with BMI >=50 (OR=2.40,P=0.070).
Conclusions: Patients with BMI greater than 40 were more likely to develop renal insufficiency postoperatively. BMI can serve as an independent predictor of renal dysfunction.
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