Obesity, Outcomes and Quality of Care: BMI Increases the Risk of Wound-Related Complications in Colon Cancer Surgery

Background—Obese patients may face higher complication rates during surgical treatment of colon cancer. This paper aims to measure this effect in a high volume tertiary care center. Methods—All colon cancer patients treated surgically at our center from 2004 through 2011 were reviewed. Multivariate regression assessed relationships of complications and stay outcomes with BMI controlled for age, gender, comorbidity score, surgical approach and history of smoking. Results—In 1048 included patients, BMI was a predictor of several complications in both laparoscopic and open procedures. For every increase of BMI by one WHO category, the odds ratio (OR) was 1.61 (p<0.001) for wound infection and OR=1.54 for slow healing (p<0.001). Additionally, right colectomies had an OR=3.23 (p=0.017) for wound dehiscence. No further associations with BMI were found. Conclusions—BMI was incrementally associated with wound-related complications, illustrating how the proliferation of obesity relates to a growing risk of surgical complications. As the surgical community strives to improve quality of care, patient controllable factors will play an increasingly important role in cost containment and quality improvement.