Belly Fat Widens Odds of Emergency Surgery Troubles
MONDAY, Oct. 30, 2017 -- Excess belly fat dramatically increases the risk of complications and death after emergency surgery, a new study finds.
The research included more than 600 patients who had emergency surgery and underwent CT scans of the abdomen and pelvis before surgery. These scans were used to calculate waist-to-hip ratios, a measure of belly fat. A healthy ratio should not exceed .90 in men and .85 in women, according to the World Health Organization.
Nearly 70 percent of the patients in the study had an unhealthy waist-to-hip ratio equal to or higher than 1.
"Our main goal is to identify those at risk for developing complications so we can intervene appropriately and improve the health care delivered," said study lead author Dr. Faisal Jehan, a research fellow in the department of surgery at the University of Arizona, Tucson.
Overall, the complication rate was 33 percent and the death rate was 4 percent. The average hospital stay was four days, and the 30-day hospital readmission rate was 25 percent.
But for people with excess belly fat, complication rates were 44 percent compared to 9 percent for those with slimmer middles. The death rate was nearly 8 percent for those with more belly fat compared to 1 percent for those with slender bellies.
Hospital stays were more than doubled for those with excess belly fat, and hospital readmission was 32.5 percent versus 7 percent for those without excess belly fat.
The researchers also found that a waist-to-hip ratio of 1 or more was an independent predictor of complications and death, increasing the odds by seven and six times, respectively.
The study was presented last week at the American College of Surgeons (ACS) meeting, in San Diego. Findings presented at meetings are usually considered preliminary until they've been published in a peer-reviewed journal.
The findings are important because at least two-thirds of Americans are overweight or obese.
"Based on the waist-to-hip ratio, we can predict whether these patients are high-risk and then take precautions to keep these patients on the radar. For example, we can call them in for postoperative examinations to check on them early and quickly, and if they do develop complications, we can quickly move them into the ICU so that we can take care of those complications," Jehan explained in an ACS news release.
Body mass index (BMI) is not as effective as waist-to-hip ratio in assessing risk, according to the researchers. BMI is a measure of body fat based on height and weight.
"The BMI has traditionally been used in hospitals to predict adverse outcomes such as heart attacks, but one of the problems with BMI is that it doesn't take into account body fat distribution," Jehan said.
"The waist-to-hip ratio, however, specifically targets the concentration of visceral fat, which is the dangerous type surrounding abdominal organs," he said.
Most people who end up needing emergency surgery have a CT scan done for other reasons. In such a case, it's reasonable to use CT scanning to measure belly fat. If a CT scan hasn't been done, a measuring tape can be used to calculate waist-to-hip ratio, the researchers said.
The U.S. Centers for Disease Control and Prevention has more on weight.
Posted: October 2017