DOI: 10.36347/sjams.2022.v10i08.011

Pages: 1234-1240

Introduction: Obesity is a major health problem in western society with rapidly increasing prevalence in most countries. The healthcare burden of obesity is far reaching but many of the consequences are yet to be fully understood. While there is a perception that obesity negatively impacts on outcomes following abdominal surgery there is conflicting evidence for this. Aims: To identify the complications of post-operative obese patients. Methods: Between 1st September, 2016 and 28th February, 2017, patients undergoing GIT, Hepatobilliary and Urological surgery at Shaheed Ziaur Rahman Medical College Hospital in Bogura, Bangladesh were enrolled. Following informed consent, BMI was assessed. High risk patients and complications were identified according to established criteria. Patients were grouped according to BMI categories as Normal, overweight, Obese grade-I and Obese grade-II. A Cost analysis was performed on all patients treated at Shaheed Ziaur Rahman Medical College Hospital using a SQL database. The cost of treatment was analysed with respect to the same BMI catagories. Results: A literature review found evidence of increased risk of wound infection, anastomotic leak, and pulmonary and thrombo-embolic risk. There was mixed evidence or no evidence that obesity increases cardiac risk, sepsis, overall morbidity and mortality or overall cost. A cohort of 100 patients was analysed. Diabetes was more common with increased BMI (p=0.017). Other categories of operative risk were not different. There was no difference in overall morbidity (p=0.903). Obese patients were more expensive than normal weight patients ($9587 versus $5,786(p<0.05)). Conclusion: This study demonstrates that obesity, measured by BMI is associated with more severe morbidity. I have also demonstrated that excess body fat as measured by BMI is associated with a significantly increased cost of treatment (36%) for patients undergoing major abdominal surgery.