8 research outputs found
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial
- Author
- Abbas J
- Abbate A
- Abdullakutty J
- Abhyanakar AD
- Aboyans V
- Abrantes JAM
- Abu-Fadel M
- Acevedo M
- Adamkova V
- Adhyapak S
- Agarwal H
- Aggarwal R
- Aggarwal RK
- Aguirre A
- Ahmed H
- Ahremark U
- Ahuad Guerrero RA
- Aidar Ayoub JC
- Airaksinen JK
- Aitken D
- Akatova E
- Akhter F
- Ako J
- Akright L
- Akyea-Djamson A
- Al Joundi T
- Al-Windy NYY
- Alan D
- Alcocer Gamba MA
- Alexander JH
- Alexander K
- Alexandru TM
- Alings M
- Alonso Martin JJ
- Alvarisqueta AF
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- Amarasekera S
- Amarasena N
- Amir O
- Amlani M
- Amosova E
- Amuchastegui M
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- Yin W-H
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- Yoon JH
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- Zahger D
- Zaidman CJ
- Zainea M
- Zaman A
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- Zhang W
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- Zong W
- Zrazhevsky K
- Zuniga JDH
- Zurakowski A
- Zuran I
- Zweiker R
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2019
- Field of study
Aims The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p
Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial
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- Vincendet M
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- Vo A
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- Voevoda MI
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- Vohra R
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- Vrolix MCM
- Vulic D
- Vuurmans T
- Wada A
- Waider W
- Waisman GD
- Waites JH
- Wali A
- Walichiewicz PM
- Waltenberger J
- Waltman J
- Wang J
- Wang J
- Wang J
- Wattanakit K
- Wei M
- Weidinger F
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- Weintraub H
- Weissbrodt M
- Welka S
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- Werner N
- Westbrook M
- Westerhausen D
- Whitaker J
- White HD
- White L
- White M
- Wiersma JJ
- Wilkins G
- Wilkinson P
- Willems FF
- Wilson MD
- Winkelmann B
- Wiseman A
- Witt N
- Wlodarczak A
- Wojewod P
- Wollaert B
- Wong Y-K
- Wongpraparut N
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- Wright S
- Wu C
- Xavier D
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- Xu B
- Xu D
- Xu X
- Xu Y
- Yagensky A
- Yakushin S
- Yan AT-K
- Yan BPY
- Yanez M
- Yang E
- Yang X
- Yang X
- Yao Z
- Yazdani S
- Yerra SK
- Yin W-H
- Yong H
- Yoon JH
- Younis L
- Yu Y
- Yuan Z
- Yusoff K
- Yusoff K
- Zahger D
- Zaidman CJ
- Zainea M
- Zaman A
- Zapata G
- Zdravko B
- Zea Nunez CA
- Zeiher AM
- Zeiher AM
- Zhang R
- Zhang W
- Zhang X
- Zhang Z
- Zhao X
- Zheleznyy V
- Zheng Y
- Zheng Z
- Zhou Y
- Zhu C
- Zhu H
- Zhu J
- Zirlik A
- Zizka J
- Zobouyan I
- Zong W
- Zrazhevsky K
- Zurakowski A
- Zuran I
- Zweiker R
- Publication venue
- 'Ovid Technologies (Wolters Kluwer Health)'
- Publication date
- 04/01/2019
- Field of study
Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402
Bare metal stent implantation in large-sized unprotected left main coronary artery stenosis in the drug-eluting stent era
- Author
- A Black
- A Chieffo
- A Chieffo
- A Migliorini
- BR Brueren
- Eisho Kyo
- FB Hu
- JS Lezo de
- KA Eagle
- Kenshi Harita
- Kunihiko Kosuga
- KW Baran
- M Samartin
- M Silvestri
- Masaharu Okada
- Mitsuru Ishii
- MJ Price
- P Agostoni
- S Park
- SC Smith Jr
- Shigeru Ikeguchi
- Shinsaku Takeda
- SJ Park
- SJ Park
- Soji Nishio
- Takafumi Tsuji
- Tatuhiko Hata
- Yoshitaka Kawata
- Yuzo Takeuchi
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Inflammatory Diseases of the Coronary Arteries
- Author
- A Doria
- A Frustaci
- A Grasland
- A Gulati
- A Hata
- A Kussmaul
- A Mahr
- A McNeal-Davidson
- A Mekinian
- A Rodriguez-Pla
- AD Cochrane
- AD Wagner
- AE Voskuyl
- AG Rose
- AH Rowley
- AH Rowley
- AH Tremoulet
- AJ Mohammad
- AJ Silman
- AK Bidani
- AM Abdul-Rahman
- AN Morrison
- AS Ormerod
- AV Marzano
- AZ Baer
- B Karger
- B Yanagawa
- BF Haynes
- BH Zhu
- BJ McMahon
- BK Sharma
- BK Sharma
- BL Richards
- BR Brueren
- C Agard
- C Canpolat
- C Comarmond
- C Comarmond
- C Hello Le
- C Mukhtyar
- C Pagnoux
- C Pagnoux
- C Ribi
- C Salvarani
- C Salvarani
- C Salvarani
- C Salvarani
- C Salvarani
- C Vuran
- CA Langford
- CA Roldan
- CC Chan
- CJ Allsop
- CM Weyand
- CM Weyand
- CM Weyand
- CM Weyand
- CR Morris
- D Kastner
- DC Chung
- DE Furst
- DG Scott
- DM Drossner
- DM Nuenninghoff
- DR Holsinger
- E Galve
- E Libman
- E Lupi-Herrera
- E Reinhold-Keller
- E Tsuda
- E Tsuda
- EF Chakravarty
- ES Leib
- ES Molloy
- ET McWilliams
- F Numano
- F Rojo-Leyva
- F Tanaka
- F Tato
- G Haberhauer
- G Haugeberg
- G Haugeberg
- G Nesher
- G Srinivasan
- GF Greil
- GG Hunder
- GG Hunder
- GJ Pons-Estel
- GS Hoffman
- GS Kerr
- GW Gong
- GW Smetana
- H Kato
- H Kato
- H Kato
- H Kobayashi
- H Maradit-Kremers
- H Muta
- H Nakano
- H Ozdemir
- H Ueda
- HL Rittner
- HY Lee
- I Branislava
- I Isohisa
- I Marie
- I Moyssakis
- I Tasdemir
- J Amano
- J Cremer
- J Deng
- JA Avina-Zubieta
- JA Jover
- JC Burns
- JC Jennette
- JF Martin
- JF Tseng
- JH Shelhamer
- JH Stone
- JJ Yu
- JL Lee
- JM Esdaile
- JM Evans
- JM Evans
- JM Garcia Vazquez
- JM Kahlenberg
- JM Orenstein
- JP Breinholt 3rd
- JS Goodwin
- JS Hui-Yuen
- JS Kim
- JT Lie
- JT Lie
- JW Cohen Tervaert
- JW Newburger
- JW Newburger
- JW Paulley
- JW Paulley
- JZ Livingston
- JZ Przybojewski
- K Boven
- K Durongpisitkul
- K Furusho
- K Maksimowicz-McKinnon
- K Maksimowicz-McKinnon
- K Punamiya
- KA Taubert
- KH Chu
- L Arnaud
- L Guillevin
- L Guillevin
- L Innala
- L Josselin-Mahr
- LS Magder
- LW Lin
- M Abe
- M Bossert
- M Bredemeier
- M Endo
- M Gayraud
- M Hammer
- M Harada
- M Ishii
- M Ishii
- M Kaiser
- M Ramos-Casals
- M Seitz
- M Sonnenblick
- M Takahashi
- M Terai
- M Yuce
- MA Gonzalez-Gay
- MA Gonzalez-Gay
- MA Portman
- MB Son
- MH Park
- MJ Burke
- ML Schrader
- MT Carpenter
- N Nishimoto
- N Noto
- N Pipitone
- N Sugihara
- N Weidner
- NF Choueiter
- NJ Luca
- NK Mehra
- P Godoy
- P Heno
- P Kumar
- P Vaideeswar
- PG Danias
- PK Min
- PK O’Brien
- PP Frohnert
- R Koivuniemi
- R Marla
- R Uehara
- RA Pick
- RA Watts
- RC Holman
- RC Holman
- RC Lawrence
- RC Stacy
- RF Spiera
- RM Rennebohm
- RS Weinstein
- RS Yeung
- RV Hicks
- S Doornum Van
- S Furukawa
- S Kitamura
- S Manzi
- S Mavrogeni
- S Mavrogeni
- S Odhav
- S Sohn
- S Unizony
- SD Resnick
- SL Hupp
- SL Mackie
- SS Hayreh
- T Akagi
- T Akagi
- T Freddo
- T Fujiwara
- T Hara
- T Ichiyama
- T Kimura
- T Kimura
- T Kobayashi
- T Kobayashi
- T Matsubara
- T Morita
- T Nakamura
- T Neumann
- T Sugimura
- T Sugiura
- T Weyn
- TE Capannari
- TE Hong
- TM Zizic
- V Devauchelle-Pensec
- WA Schmidt
- WA Schmidt
- WB Lebowitz
- WH Leung
- WP Arend
- Y Nakamura
- Y Nakamura
- Y Seko
- Y Sugahara
- Y Yoshikawa
- YB Park
- YF Cheung
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Inflammatory Diseases of the Coronary Arteries
- Author
- A Doria
- A Frustaci
- A Grasland
- A Gulati
- A Hata
- A Kussmaul
- A Mahr
- A McNeal-Davidson
- A Mekinian
- A Rodriguez-Pla
- AD Cochrane
- AD Wagner
- AE Voskuyl
- AG Rose
- AH Rowley
- AH Rowley
- AH Tremoulet
- AJ Mohammad
- AJ Silman
- AK Bidani
- AM Abdul-Rahman
- AN Morrison
- AS Ormerod
- AV Marzano
- AZ Baer
- B Karger
- B Yanagawa
- BF Haynes
- BH Zhu
- BJ McMahon
- BK Sharma
- BK Sharma
- BL Richards
- BR Brueren
- C Agard
- C Canpolat
- C Comarmond
- C Comarmond
- C Hello Le
- C Mukhtyar
- C Pagnoux
- C Pagnoux
- C Ribi
- C Salvarani
- C Salvarani
- C Salvarani
- C Salvarani
- C Salvarani
- C Vuran
- CA Langford
- CA Roldan
- CC Chan
- CJ Allsop
- CM Weyand
- CM Weyand
- CM Weyand
- CM Weyand
- CR Morris
- D Kastner
- DC Chung
- DE Furst
- DG Scott
- DM Drossner
- DM Nuenninghoff
- DR Holsinger
- E Galve
- E Libman
- E Lupi-Herrera
- E Reinhold-Keller
- E Tsuda
- E Tsuda
- EF Chakravarty
- ES Leib
- ES Molloy
- ET McWilliams
- F Numano
- F Rojo-Leyva
- F Tanaka
- F Tato
- G Haberhauer
- G Haugeberg
- G Haugeberg
- G Nesher
- G Srinivasan
- GF Greil
- GG Hunder
- GG Hunder
- GJ Pons-Estel
- GS Hoffman
- GS Kerr
- GW Gong
- GW Smetana
- H Kato
- H Kato
- H Kato
- H Kobayashi
- H Maradit-Kremers
- H Muta
- H Nakano
- H Ozdemir
- H Ueda
- HL Rittner
- HY Lee
- I Branislava
- I Isohisa
- I Marie
- I Moyssakis
- I Tasdemir
- J Amano
- J Cremer
- J Deng
- JA Avina-Zubieta
- JA Jover
- JC Burns
- JC Jennette
- JF Martin
- JF Tseng
- JH Shelhamer
- JH Stone
- JJ Yu
- JL Lee
- JM Esdaile
- JM Evans
- JM Evans
- JM Garcia Vazquez
- JM Kahlenberg
- JM Orenstein
- JP Breinholt 3rd
- JS Goodwin
- JS Hui-Yuen
- JS Kim
- JT Lie
- JT Lie
- JW Cohen Tervaert
- JW Newburger
- JW Newburger
- JW Paulley
- JW Paulley
- JZ Livingston
- JZ Przybojewski
- K Boven
- K Durongpisitkul
- K Furusho
- K Maksimowicz-McKinnon
- K Maksimowicz-McKinnon
- K Punamiya
- KA Taubert
- KH Chu
- L Arnaud
- L Guillevin
- L Guillevin
- L Innala
- L Josselin-Mahr
- LS Magder
- LW Lin
- M Abe
- M Bossert
- M Bredemeier
- M Endo
- M Gayraud
- M Hammer
- M Harada
- M Ishii
- M Ishii
- M Kaiser
- M Ramos-Casals
- M Seitz
- M Sonnenblick
- M Takahashi
- M Terai
- M Yuce
- MA Gonzalez-Gay
- MA Gonzalez-Gay
- MA Portman
- MB Son
- MH Park
- MJ Burke
- ML Schrader
- MT Carpenter
- N Nishimoto
- N Noto
- N Pipitone
- N Sugihara
- N Weidner
- NF Choueiter
- NJ Luca
- NK Mehra
- P Godoy
- P Heno
- P Kumar
- P Vaideeswar
- PG Danias
- PK Min
- PK O’Brien
- PP Frohnert
- R Koivuniemi
- R Marla
- R Uehara
- RA Pick
- RA Watts
- RC Holman
- RC Holman
- RC Lawrence
- RC Stacy
- RF Spiera
- RM Rennebohm
- RS Weinstein
- RS Yeung
- RV Hicks
- S Doornum Van
- S Furukawa
- S Kitamura
- S Manzi
- S Mavrogeni
- S Mavrogeni
- S Odhav
- S Sohn
- S Unizony
- SD Resnick
- SL Hupp
- SL Mackie
- SS Hayreh
- T Akagi
- T Akagi
- T Freddo
- T Fujiwara
- T Hara
- T Ichiyama
- T Kimura
- T Kimura
- T Kobayashi
- T Kobayashi
- T Matsubara
- T Morita
- T Nakamura
- T Neumann
- T Sugimura
- T Sugiura
- T Weyn
- TE Capannari
- TE Hong
- TM Zizic
- V Devauchelle-Pensec
- WA Schmidt
- WA Schmidt
- WB Lebowitz
- WH Leung
- WP Arend
- Y Nakamura
- Y Nakamura
- Y Seko
- Y Sugahara
- Y Yoshikawa
- YB Park
- YF Cheung
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Risk categorization using New American College of Cardiology/American Heart Association guidelines for cholesterol management and its relation to alirocumab treatment following acute coronary syndromes
- Author
- Abbas J
- Abbate A
- Abdullakutty J
- Abdullkutty J
- Abhyanakar AD
- Aboyans V
- Abrantes JAM
- Abu-Fadel M
- Acevedo M
- Adamkova V
- Adamo A
- Adhyapak S
- Agarwal H
- Aggarwal R
- Aggarwal RK
- Agnetti V
- Aguirre A
- Ahmed H
- Ahremark U
- Ahuad Guerrero RA
- Aidar Ayoub JC
- Airaksinen JK
- Aitken D
- Akatova E
- Akhter F
- Ako J
- Akright L
- Akyea-Djamson A
- Al Joundi T
- Al-Windy NYY
- Alan D
- Alcocer Gamba MA
- Alexander JH
- Alexander K
- Alexandru TM
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- Alings M
- Alonso Martin JJ
- Alonso Orcajo N
- Alsweiler C
- Alvarisqueta AF
- Alves De Lima AE
- Amarasekera S
- Amarasena N
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- Amosova E
- Amuchastegui M
- Anchante Hernandez HA
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- Zurakowski A
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- Zweiker R
- Publication venue
- 'Ovid Technologies (Wolters Kluwer Health)'
- Publication date
- 01/08/2019
- Field of study
Background: The 2018 US cholesterol management guidelines recommend additional lipid-lowering therapies for secondary prevention in patients with low-density lipoprotein cholesterol ≥70 mg/dL or non−high-density lipoprotein cholesterol ≥100 mg/dL despite maximum tolerated statin therapy. Such patients are considered at very high risk (VHR) based on a history of >1 major atherosclerotic cardiovascular disease (ASCVD) event or a single ASCVD event and multiple high-risk conditions. We investigated the association of US guideline-defined risk categories with the occurrence of ischemic events after acute coronary syndrome and reduction of those events by alirocumab, a PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor. Methods: In the ODYSSEY OUTCOMES trial (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab), patients with recent acute coronary syndrome and residual dyslipidemia despite optimal statin therapy were randomly assigned to alirocumab or placebo. The primary trial outcome (major adverse cardiovascular events, ie, coronary heart disease death, nonfatal myocardial infarction, ischemic stroke, or hospitalization for unstable angina) was examined according to American College of Cardiology/American Heart Association risk category. Results: Of 18 924 participants followed for a median of 2.8 years, 11 935 (63.1%) were classified as VHR: 4450 (37.3%) had multiple prior ASCVD events and 7485 (62.7%) had 1 major ASCVD event and multiple high-risk conditions. Major adverse cardiovascular events occurred in 14.4% of placebo-treated patients at VHR versus 5.6% of those not at VHR. In the VHR category, major adverse cardiovascular events occurred in 20.4% with multiple prior ASCVD events versus 10.7% with 1 ASCVD event and multiple high-risk conditions. Alirocumab was associated with consistent relative risk reductions in both risk categories (hazard ratio=0.84 for VHR; hazard ratio=0.86 for not VHR; Pinteraction=0.820) and by stratification within the VHR group (hazard ratio=0.86 for multiple prior ASCVD events; hazard ratio=0.82 for 1 major ASCVD event and multiple high-risk conditions; Pinteraction=0.672). The absolute risk reduction for major adverse cardiovascular events with alirocumab was numerically greater (but not statistically different) in the VHR group versus those not at VHR (2.1% versus 0.8%; Pinteraction=0.095) and among patients at VHR with multiple prior ASCVD events versus a single prior ASCVD event (2.4% versus 1.8%; Pinteraction=0.661). Conclusions: The US guideline criteria identify patients with recent acute coronary syndrome and dyslipidemia who are at VHR for recurrent ischemic events and who may derive a larger absolute benefit from treatment with alirocumab. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402
Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis
- Author
- Aarts E
- Abbas Z
- Abburu S
- Abd Ghaffar Mk
- Abdelgalil R
- Abdelhadi M
- Abdikadir Hr
- Abdulmajid A
- Abdulrahman N
- Abid A
- Abid H
- Abrisqueta Carrion J
- Abuhussein N
- Abul Mh
- Acar S
- Acherman Yiz
- Acquaah F
- Acres M
- Adams R
- Adams Rd
- Adebayo Aa
- Adeleja I
- Adiyaman C
- Adjei H
- Adlan A
- Afzal Z
- Agalar C
- Agarwal V
- Agrawal M
- Ahern N
- Ahmad A
- Ahmad K
- Ahmad S
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- Ahmed H
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- Aidoo-Micah Ge
- Aildasani L
- Aithie Jm
- Akbulut F
- Akcaoglu T
- Akdogan A
- Akhtar S
- Akkaya E
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- Aksoy K
- Aktas Mk
- Aktekin H
- Al-Mousawi A
- Al-Nasser A
- Al-Nasser Z
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- Al-Robeye A
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- Alberdi San Roman I
- Alberti Delgado P
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- Facchiano A
- Falcon Cazas A
- Fares Da
- Farina V
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- Fasano A
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- Hirani S
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- Holloway C
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- Howard James N
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- Huseynova S
- Husnoo Sb
- Hussain N
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- Hutchings I
- Huzmeli E
- Ibrahim A
- Ibrahim I
- Ilbak A
- Inci Et
- Ingham R
- Ingram E
- Innocenti P
- Iorga R
- Iqbal A
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- Isaac A
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- Jimenez-Gomez Lm
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- Karabulut E
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- Kennedy Ed
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- Kerai A
- Kerimova N
- Kerin Mj
- Kerr Al
- Keyif Mf
- Khaing Ph
- Khajuria A
- Khalid H
- Khan A
- Khan I
- Khan M
- Khan S
- Khan T
- Khan U
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- Khanijau R
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- Khetarpal Aa
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- Khonat Z
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- Kitt H
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- Knight Cl
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- Laurino A
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- Martin Morales E
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- Nepogodiev D
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- Pizzolato A
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- Skalamera I
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- Soo Yh
- Soon Wc
- Sorah T
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- Sotona O
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- Steup Wh
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- Stijns Rch
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- Sullivan Jal
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- Taşçı Y
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- Yilmaz M
- Yilmaz S
- Yilmaz T
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- Yoganathan S
- Yong Cs
- Yong N
- Yoruk I
- Yousif A
- Yow L
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- Yurekli Am
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- Zope S
- Zuhair M
- Örhalmi J
- Özkan Bb
- Šimáčková B
- Široká M
- Žebrák R
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2018
- Field of study
Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien\u2013Dindo Grades III\u2013V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49\u20132.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46\u20130.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease
Body mass index and complications following major gastrointestinal surgery: a prospective, international cohort study and meta-analysis.
- Author
- 6rhalmi J
- 6zkan Bb
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- Husnoo Sb
- Hussain N
- Hussain O
- Hutchings I
- Huzmeli E
- Ibrahim A
- Ibrahim I
- Ilbak A
- Inci Et
- Ingham R
- Ingram E
- Innocenti P
- Iorga R
- Iqbal A
- Iqbal S
- Isaac A
- Isler Vc
- Iyer S
- Jackson Hr
- Jackson S
- Jacob L
- Jafree Dj
- Jaitley A
- Jalota P
- Jamal N
- Janssen Tl
- Jaro\u161 J
- Jathanna N
- Jawad As
- Jayakody N
- Jenkin Sl
- Jenvey C
- Jewell Pd
- Jeyabraba S
- Jhala H
- Jim\ue9nez-Morillas P
- Jim\ue9nez-Vi\uf1as C
- Jimenez Escovar F
- Jimenez-Gomez Lm
- Jimenez-Segovia M
- Jindal A
- Johnston A
- Johnston J
- Johnstone M
- Jones Cs
- Jong N
- Jordan Hem
- Joshi D
- Joshi Kr
- Joyce Hl
- Joyner C
- Jubainville Cl
- Jull P
- Jurgens J
- Kabariti R
- Kadicheeni M
- Kahar A
- Kakil E
- Kalra N
- Kamarajah Sk
- Kanabar S
- Kane T
- Kankam Hkn
- Kar\ue1sek D
- Kara B
- Kara C
- Kara E
- Karabacak U
- Karabulut E
- Karahan B
- Karia M
- Karia P
- Karsan Rb
- Karunakaran P
- Kasap S
- Kasar P
- Kaushal A
- Kaya A
- Kayacan S
- Kayaci Durak M
- Kazmi Z
- Keane Cp
- Keane N
- Keane P
- Kee Jy
- Keeling Re
- Keelty N
- Keevil H
- Kelesoglu Y
- Kelly M
- Kelly Me
- Kelly N
- Kennedy Ed
- Kennedy Hr
- Kerai A
- Kerimova N
- Kerin Mj
- Kerr Al
- Keyif Mf
- Khaing Ph
- Khajuria A
- Khalid H
- Khan A
- Khan I
- Khan M
- Khan S
- Khan T
- Khan U
- Khangura J
- Khanijau R
- Khatri C
- Khattak M
- Khetarpal Aa
- Khokhar Ha
- Khonat Z
- Khonsari P
- Kiely A
- Kiff R
- Kilic E
- Kilinc C
- Kim Jw
- Kim S
- Kimani L
- King M
- Kip M
- Kishore A
- Kisyov I
- Kitt H
- Kleine E
- Klinkert M
- Kloppenberg Fwh
- Knight Cl
- Ko\ue7 F
- Ko\ue7 M
- Kobal Bb
- Koc Ge
- Kocapinar S
- Kocer Md
- Koksal G
- Koksal S
- Kong C
- Kong Cy
- Konsten J
- Kopac O
- Koppe M
- Kosasih Sr
- Koshy Rm
- Kotecha D
- Koumpa F
- Kow K
- Koysombat K
- Kreibich A
- Kretzmer L
- Kucukdiler E
- Kuiper J
- Kuiper Sz
- Kullac S
- Kumar An
- Kumaran G
- Kurklu O
- Kurt A
- Kuzey A
- Kwan Ml
- Kwang P
- L\uf3pez-M\ue1rmol R
- L\uf3pez-Vendrell L
- L\uf6wensteyn Yn
- Laguna Rom\ue1n S
- Lakhani M
- Lakhani Sm
- Lakshmipathy G
- Lalor P
- Lamont J
- Langenhoff B
- Lankage Cm
- Lap Cr
- Larotonda C
- Laterza V
- Latras-Cort\ue9s I
- Laurino A
- Lavery J
- Lazenby D
- Leafe O
- Ledsam A
- Lee Ahy
- Lee J
- Lee S
- Lees Dm
- Lek C
- Leong S
- Leslie Ke
- Leung W
- Leventoglu S
- Lewis T
- Li Hi Shing S
- Li Mm
- Li N
- Licari L
- Liew W
- Liew Y
- Lim Ae
- Lim D
- Lim E
- Lim J
- Lim K
- Lim S
- Lim Sj
- Linton A
- Liu C
- Liu S
- Livesey A
- Lo Secco G
- Lo T
- Lockey Jw
- Logan Ae
- Loke W
- Long F
- Long K
- Longstaff L
- Loo J
- Looijen Rc
- Lopes S
- Lopez Garcia Mc
- Lopez G
- Lotfallah A
- Lou Cn
- Loughran D
- Loveday J
- Low Jyl
- Lowe R
- Lu Q
- Lua Boon Xuan J
- Lucas de Carvalho J
- Luehrman A
- Luhishi A
- Lujan Mompean Ja
- Luk Cy
- Lunawat S
- Lwin Kn
- Lykoudis Pm
- Lynch As
- Lynne S
- Lyons A
- Lyons R
- Maamari R
- Maan Ds
- Macaskill A
- Macdonald A
- Macdonald J
- Macha\u10dov\ue1 A
- Mackin S
- Maclennan D
- Magnoli M
- Mah J
- Mahboob S
- Mahesh S
- Maheswaran Y
- Mahmood J
- Majid S
- Major C
- Malaj M
- Malak M
- Malik A
- Mallick S
- Malys Mk
- Manson R
- Mansoor S
- Manvydas V
- Maple N
- Marchal St
- Marchese N
- Marcos Rodrigo A
- Mariani F
- Markham Rm
- Marsden M
- Marsh A
- Marsh L
- Marshall Dc
- Mart\ued Fern\ue1ndez Rm
- Mart\uednez Chillar\uf3n E
- Marti Gelonch L
- Martin Morales E
- Martin Al
- Martin R
- Martinez Diaz Jm
- Martinez Rios Ce
- Martorana M
- Maru D
- Mason Jd
- Masood M
- Mastan A
- Mastandrea Bonaviri Gn
- Mate-Mate P
- Matheson J
- Matthams J
- Matthews Bw
- Matthews Jh
- Mauro D
- Maxwell-Armstrong C
- Mayes Jw
- Mazan K
- Mazumdar E
- Mcaleer E
- Mcaleer S
- Mcallister R
- Mcauley D
- Mcbride A
- Mccabe G
- Mccance E
- Mccann M
- Mcclymont Lf
- Mccormack Dr
- Mccrann C
- Mcdowell M
- Mcenhill Pm
- Mcfarlane H
- Mcgalliard Rj
- Mcgarrigle C
- Mcgarvie S
- Mcgenity C
- Mcgowan C
- Mcgrath A
- Mcgregor Rj
- Mcintyre Cj
- Mckean E
- Mckelvey Ll
- Mckerr Cn
- Mckevitt Kl
- Mclaughin C
- Mclean Rc
- Mclure Sw
- Mcmenamin M
- Mcmullan R
- Mcnamee L
- Mcrobbie Hd
- Medina-Fern\ue1ndez Fj
- Meek J
- Mehdi A
- Mehta Jk
- Meijerink Wjhj
- Menduni N
- Menon A
- Mensink G
- Mericliler M
- Mermer S
- Messina F
- Mestres Petit N
- Metcalf P
- Mian A
- Milana F
- Milazzo Lf
- Millan M
- Mills Ed
- Mills H
- Mills M
- Milne S
- Minhas M
- Mirallas Vi\uf1as O
- Miranda Bh
- Mirdavoudi V
- Mirza M
- Mishra A
- Mistry Bd
- Mistry S
- Mitchell H
- Mitha N
- Mithrakumar P
- Mitrasinovic S
- Mittapalli D
- Mitxelena Elosegi L
- Mizan Sr
- Mogan Yp
- Mohamed Us
- Mohamud M
- Mohan K
- Mohan M
- Mohite A
- Momoh Z
- Montanelli P
- Montuori M
- Monzonis Hernandez X
- Moody N
- Moon Rdc
- Moradzadeh J
- Moran D
- Morandi V
- Moratilla Lape\uf1a L
- Morgan C
- Morgan F
- Morino M
- Morley R
- Moroni P
- Morris F
- Morris S
- Morrison Cj
- Morrison P
- Mortimer A
- Morton D
- Mosterd Cm
- Mugurtay Ys
- Mulder Im
- Muller S
- Mural-Krishnan S
- Muriel P
- Murkin C
- Muro M
- Murphy L
- Murray Se
- Murtaza A
- Murtaza Mi
- Mushtaq J
- Mustafa S
- Musters Gd
- Mutlu B
- Mutlu D
- Myers L
- Naccari P
- Naccari Pm
- Nachiappan R
- Nadanakumaran K
- Naqib S
- Narain A
- Naran P
- Narang Y
- Narayan P
- Narramore R
- Narwani V
- Navayogaarajah V
- Naveed H
- Nayee H
- Neary A
- Nehikhare I
- Nelaj S
- Nelli T
- Neo Yn
- Neophytou C
- Nepogodiev D.
- Nesargikar Pn
- Ng Ayl
- Ng Gs
- Ng Jck
- Ng Jq
- Ng K
- Ng L
- Ng S
- Ngaage M
- Nicholls K
- Nixon G
- Noone Tm
- Norris Jm
- North As
- Norton J
- Nota Clma
- Notarnicola M
- Ntala C
- O'Bryan M
- O'Byrne L
- O'Carroll O
- O'Connell C
- O'Connor A
- O'Connor S
- O'Dwyer M
- O'Flynn Ld
- O'Kane A
- O'Loughlin Ra
- O'Neill Em
- O'Neill S
- O'Reilly D
- O'Sullivan Da
- O'Sullivan H
- O'Sullivan K
- Oakley T
- Obute Rd
- Odeleye A
- Ogunleye O
- Olivier J
- Omar A
- Omara S
- Omer Hm
- Onar D
- Oncel M
- Ong Kk
- Onsal U
- Oostendorp Se
- Oremule B
- Orhalmi J
- Orhan K
- Osei-Kuffour D
- Osman S
- Oudman Ts
- Oun H
- Owasil R
- Owczarek S
- Ozbalci Gs
- Ozben V
- Ozgencil B
- Ozmen Bb
- Ozsipahi Ac
- P\uf6s M
- Padilla Valverde D
- Paine Hr
- Pal S
- Palanivail N
- Palkhi E
- Pallara E
- Palmer C
- Palmieri A
- Palmisano S
- Palos Campos Mc
- Palyzov\ue1 H
- Pandey A
- Pandey G
- Pando Ruiz B
- Pang G
- Pantalone Mr
- Paolo G
- Papandrea M
- Papazachariou Sk
- Parajo A
- Paraoan V
- Parimli H
- Parinisi Z
- Park Jh
- Parker J
- Parker O
- Parkin J
- Parmar E
- Parsons S
- Parthiban S
- Pasquali S
- Pasqualoni M
- Pastor-Riquelme P
- Pata F
- Patel B
- Patel Ba
- Patel By
- Patel Jb
- Patel K
- Patel M
- Patel N
- Patel P
- Patel S
- Patel T
- Patel V
- Pattapola V
- Patturelli M
- Paul J
- Pearce J
- Pearse Rj
- Peck Fs
- Pehlivan M
- Peinado Iribar B
- Pektas Am
- Pellino G
- Perera M
- Perez Arias H
- Perez Costoya C
- Perez Febles M
- Perez Jl
- Perez-Gandara B
- Pericleous A
- Peroos S
- Perrotta G
- Persiani R
- Pesser N
- Peters M
- Petra H
- Petrarca M
- Petrov G
- Pezas Tp
- Pezzuto R
- Phan Pn
- Phillips C
- Picciariello A
- Pickard J
- Pietrabissa A
- Pike G
- Pine\uf1o-Flores C
- Pinkney Td
- Pinto R
- Piquet A
- Piraliyev E
- Piran G
- Pistola I
- Pitts-Tucker T
- Pizzolato A
- Pla Ser\uf3 S
- Player C
- Plomer-Sanchez M
- Poacher A
- Poelman M
- Polat F
- Polat Zp
- Ponweera A
- Poo Sx
- Pope S
- Portugal Porras V
- Posada M
- Posteki G
- Poyato Nu\uf1ez Fj
- Prabhudesai A
- Prado Perez R
- Prakash E
- Preece R
- Prest-Smith J
- Priani P
- Priestland R
- Prieto-Nieto Mi
- Pronk A
- Protti Ruiz Gp
- Prys-Jones O
- Ptacek Ib
- Puan L
- Puccioni C
- Pujol-Cano N
- Pulpito S
- Punj R
- Punjabi N
- Qamar Ma
- Quill S
- Quinn K
- Qureshi A
- Qureshi S
- Qureshi U
- Rabinthiran S
- Radotra A
- Rafiq Nm
- Raghuvir V
- Raghvani T
- Rahmee Cns
- Raimondi P
- Raina V
- Rajan N
- Raji K
- Rakhimov I
- Raman Kp
- Ramana A
- Ramjeeawon N
- Ramnarine A
- Rampal R
- Rampulla V
- Ramsay N
- Ramtoola T
- Randisi B
- Rangan T
- Rangedara A
- Raphael M
- Rashid M
- Rashid S
- Rasiah Mg
- Ratnakumaran R
- Rattan G
- Ratu Sg
- Raurich-Leandro J
- Raut P
- Reakes T
- Realis Luc A
- Redgrave Na
- Redmond A
- Reed A
- Reeder C
- Reehal Rs
- Rees C
- Rees S
- Reeves T
- Reggiani L
- Reid Kg
- Reid Nb
- Reid R
- Rejayee M
- Remedios J
- Remore Lm
- Reynolds J
- Rhema Ia
- Ribbink Me
- Ridgway P
- Rinkoff S
- Ripa M
- Riva L
- Riva M
- Rizzi A
- Rob T
- Roberts Aw
- Roberts C
- Roberts Ej
- Roberts Hf
- Robertson Dt
- Robertson Kl
- Robertson V
- Robinson C
- Robinson M
- Robson J
- Rocco I
- Roche D
- Rocke As
- Rodrigues Silva K
- Rodriguez Garcia R
- Rogers Je
- Rogers S
- Rojoa D
- Romano F
- Romeo F
- Romero-Sim\uf3 M
- Rookes Cw
- Roquet Puigner\uf3 E
- Rosati G
- Rosati R
- Rosen O'Sullivan H
- Ross H
- Ross T
- Rossi E
- Rothwell L
- Roura J
- Roy Csd
- Rubbini M
- Rubio-Perez I
- Ruiz Montesinos I
- Ruiz Em
- Russell G
- Ryan M
- S\ue1nchez Est\ue9banez E
- S\ue1nchez-Blasco L
- Saat Mi
- Sabine Lm
- Sacco R
- Sagar R
- Saglam Za
- Sagmeister M
- Sahathevan A
- Sahin A
- Sait Ms
- Sajjad U
- Sakman G
- Salam Gj
- Salamone G
- Salazar-Garc\ueda C
- Sale T
- Salem M
- Salih Ae
- Salman M
- Salmon D
- Sam Zh
- Sammarco G
- Sampietro G
- San Mart\uedn Bragado M
- Sanchez Cambronero M
- Sanchez A
- Sanchez-Guillen L
- Sanders Ja
- Sandhu Kk
- Sandhu S
- Sandison L
- Sangal P
- Santocchi P
- Sanz Ortega G
- Sapci I
- Saraceno F
- Sari V
- Sartori A
- Sarvanandan T
- Sarwar S
- Sasapu K
- Satterthwaite L
- Schasfoort Ra
- Schiphorst A
- Schizas A
- Schmidt Pa
- Schofield E
- Schok T
- Schulz Tm
- Schulzov\ue1 M
- Scotcher Se
- Seager E
- Sebaoui S
- Secilmis E
- Sedee Wja
- Seedat M
- Segall E
- Segura-Sampedro Jj
- Sellathurai J
- Selvachandran H
- Selvaggi F
- Selvaggi L
- Semana Ad
- Semiz A
- Semnani Sa
- Semple E
- Sen Ay
- Sena-Ruiz F
- Senay Bb
- Seneviratne N
- Sengul N
- Sensi B
- Senturk E
- Sethi Rk
- Sette M
- Seyhan U
- Seyrek N
- Sgr\uf2 A
- Sgroi G
- Shafi Ama
- Shafiq Nm
- Shah A
- Shah Jp
- Shah R
- Shah S
- Shaheen H
- Shahid S
- Shahidi S
- Shakweh E
- Shamsul Badrin Ak
- Shanahan D
- Sharifpour M
- Sharma Khatiwada A
- Shatkar V
- Shaunak R
- Sheikh Imi
- Sheldon A
- Shepherd P
- Shepherd R
- Sherif Ma
- Sherliker Gxj
- Sheth S
- Shoa M
- Shufflebotham H
- Shuker Ba
- Shukla A
- Shumon S
- Shurovi B
- Shurovi Bn
- Shuttleworth Rh
- Sica G
- Siddiqui M
- Siddiqui Zh
- Sii S
- Sim D
- Sim Nk
- Sim P
- Simioni A
- Simon Frapolli V
- Simpson A
- Simpson R
- Singagireson S
- Singh B
- Singh K
- Singh R
- Singh S
- Sinha A
- Sinha Y
- Sirakaya M
- Sitta O
- Sivrikaya T
- Skalamera I
- Slade R
- Slieker Fjb
- Smart Nj
- Smeets Hj
- Smet M
- Smith Acd
- Smith Ag
- Smith Dne
- Smith N
- Smol\ue1k P
- Sng S
- Soldevila-Verdeguer C
- Soo Yh
- Soon Wc
- Sorah T
- Soria Aledo V
- Sotona O
- Soylemez Zobb
- Sozuer Em
- Spence O
- Spencer T
- Spijkerman R
- Springford Lr
- Sproule L
- Sreh A
- Srikantharajah M
- Sritharan P
- Staderini F
- Stanger Sa
- Stanley Gh
- Stanley S
- Stassen Lps
- Stather Pw
- Steccanella F
- Stechman M
- Steel M
- Stein J
- Stellingwerf Me
- Steup Wh
- Stevens S
- Stewart Ge
- Stezaker S
- Stijns Rch
- Stoddart Mt
- Stokes S
- Stone Ej
- Stott Gd
- Strange E
- Street An
- Subasi A
- Sukkari M
- Sukumar S
- Suleman Yn
- Sullivan Jal
- Sun E
- Sundar-Singh M
- Suppa A
- Suresh Rs
- Suresh S
- Syeed Ja
- Sykes Mc
- Szczap A
- Ta\u15f\ue7\u131 Y
- Tagariello F
- Tahir M
- Tahmina A
- Tai A
- Talukdar Ss
- Tan D
- Tan Esm
- Tan Et
- Tan R
- Tan S
- Tan Y
- Tan Yh
- Tansoker I
- Tarantino M
- Targa S
- Taskin O
- Taskin Rb
- Tavuz Ai
- Tay Ay
- Tayeh S
- Taylor F
- Tear Ak
- Teh Jw
- Teixeira da Silva M
- Tejero Pintor Fj
- Telfer R
- Temiz C
- Teng V
- Teoh Pj
- Ter Bruggen Ffja
- Ter Horst L
- Ter Weele K
- Thacoor A
- Thakker Ce
- Thakur H
- Tharakan Rg
- Tharmachandirar T
- Theodoreson Md
- Theodoropoulou K
- Thethi R
- Thevathasan Aa
- Thirumal V
- Thomas D
- Thomas G
- Thomas-Davies M
- Thompson Jd
- Thompson Od
- Tiedt L
- Tilston Tw
- Tippins F
- Tirnaksiz Mb
- Toale C
- Tognolo L
- Toh C
- Tomas K
- Toner E
- Tongo F
- Tonkins M
- Toorenvliet Br
- Topal U
- Topalan K
- Topham C
- Torlot Ge
- Torrance Hd
- Tosun V
- Toto Of
- Trail M
- Traynor Bp
- Trecarten S
- Trimble A
- Trist Aj
- Troia A
- Trompetto M
- Truma A
- Truss A
- Tsui Ay
- Tulum H
- Tung L
- Turaga S
- Turati L
- Turkmen M
- Turley H
- Turnbull Ja
- Turner Ejh
- Turner J
- Turner L
- Turner M
- Turpan M
- Tutam Dn
- Ucar E
- Uctepe F
- Uittenbogaart M
- Ulkucu A
- Ulusahin M
- Unal Ag
- Ungcharoen N
- Uppal E
- Urquhart A
- Uzun B
- Uzun O
- Uzun S
- Uzunoglu Ec
- Vable T
- Valderrama P\ue9rez A
- Valli A
- Vallve-Bernal M
- Van Bruggen D
- van Dalen Ashm
- van de Ven Awh
- van der Harst E
- van der Hoeven Ac
- Van der Lubbe M
- van der Pool Aem
- van der Zee C
- Van Dijck Wpm
- van Elst Tr
- van Engelenburg T
- van Geloven A
- Van Grevenstein Wmu
- Van Heumen Tm
- van Leeuwen Bl
- van Rijckevorsel Vajim
- van Steensel L
- Van Tol Rr
- van Verschuer Vmt
- van Wijnbergen Jwm
- Vanmali P
- Varley R
- Varma D
- Varma N
- Varma Rk
- Varo Mu\uf1oz A
- Vasko P
- Vasquez G
- Vaughan R
- Vazquez-Gonzalez I
- Veenker Cgh
- Vela Polanco Ff
- Vendramin E
- Venn M
- Ventre Cm
- Venturini S
- Verardi L
- Verboeket B
- Verma K
- Verma S
- Vermaas M
- Vernon Ok
- Vi\uf1as-Salas J
- Villarejo Campos P
- Vinci A
- Vithanage Na
- Vivekanantham S
- Vives-Rodriguez E
- Vries Jjm
- Wadanamby S
- Waldron Rm
- Walford Ra
- Wali A
- Wall C
- Walsh Sl
- Wan Jc
- Wang A
- Wang S
- Ward Ae
- Ward N
- Ward T
- Warren N
- Warwick Hl
- Watson N
- Watson Rp
- Weaver R
- Webb E
- Weinberg D
- Wells M
- Weston C
- Wetherall N
- Whacha C
- Whatling Ea
- Whewell H
- White A
- White Cj
- White U
- Whitehurst K
- Whitham Rdj
- Whittingham H
- Wiersema R
- Wiezer R
- Wijesekera M
- Wijffels N
- Wijnhoven Bpl
- Wild Jrl
- Wilkinson D
- Willems L
- Willems Yr
- Williams M
- Williams Mr
- Williams P
- Williams Rp
- Wills J
- Wilson H
- Wilson Hcp
- Wilson R
- Wilson T
- Wiltshire Jj
- Winarski A
- Wing Vc
- Wingfield Lr
- Winslow F
- Woin E
- Wong C
- Wong E
- Wong V
- Wood Ad
- Woodcock N
- Woodward H
- Woon E
- Wright A
- Wright Ev
- Wye J
- Wylam D
- Wylie J
- Wynell-Mayow Wm
- Xiao C
- Xu Gx
- Xylas D
- Y\u131gman S
- Yalcin Y
- Yaman S
- Yan A
- Yang T
- Yasar C
- Yates Ja
- Yauw S
- Yavuz G
- Yazkan Z
- Yekenkurul E
- Yener A
- Yeoh Tsl
- Yetiskin E
- Yildirim N
- Yildirim R
- Yildiz S
- Yildiz Ss
- Yildiz T
- Yilmaz I
- Yilmaz M
- Yilmaz S
- Yilmaz T
- Yim N
- Yoganathan S
- Yong Cs
- Yong N
- Yoruk I
- Yousif A
- Yow L
- Yuen R
- Yuksek B
- Yuksek Ma
- Yuksel A
- Yurdaor Ss
- Yurekli Am
- Zaidi R
- Zegeye Mi
- Zengin T
- Zhang Aa
- Zhao J
- Ziff O
- Zigiotto D
- Zijlmans Jl
- Zimmerman D
- Ziprin P
- Zope S
- Zuhair M
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2018
- Field of study
AIM:
Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data.
METHODS:
This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results.
RESULTS:
This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P < 0.001) compared to normal weight patients.
CONCLUSIONS:
In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease