A High Body Mass Index (BMI) is Associated With Incremental Health Care Utilization and Surgical Complications in Patients Undergoing Colorectal Cancer Surgery: Presidential Poster

Abstract

Introduction: Obesity is associated with an increased risk of colorectal cancer (CRC). However, there is a gap in our current knowledge regarding the impact of obesity on CRC surgery. The aim was to look at the impact of obesity and morbid obesity on post-operative outcomes of patients undergoing (CRC) surgery. Methods: Retrospective study using discharge data from the 2009 nationwide inpatient sample (NIS), healthcare cost and utilization project (HCUP). Obesity and morbid obesity were defined using ICD-9-CM codes. We compared CRC surgery patients with and without obesity and their outcomes. Results: There were 105,744 admissions for CRC surgery in 2009 with mean age of 67.7 years. Of those, 8,739 (8.26%) had obesity. Significant variables are shown in table 1 and include female sex, younger age, and African American ethnicity among obese patients. Using a multivariate regression model and after adjusting for significant covariates, obese patients had more underlying comorbidities such as hypertension [odds ratio (OR) 2.70, 95% confidence interval (CI): 2.38-3.13; p<0.0001] and renal failure (OR 2.04, 95% CI: 1.61-2.56; p<0.0001). Obesity was associated with an increased risk of poor surgical wounds healing (OR 4.16, 95% CI: 1.56-11.11; p< 0.0048). Other surgical complications were similar in both groups. By multivariate linear regression, morbidly obese patients who underwent CRC surgery had a longer length of hospital stay (p<0.003), increased total hospital charges of $4,481 (95% CI: 200-8761, p<0.040), and more frequent disposition to short term facilities (skilled nursing facility, intermediate care, or other facility excluding short term hospitals) as opposed to home (OR 2.81, 95% CI 2.17-3.63; p<0.001). Conclusion: Obese patients undergoing CRC surgery tend be younger, African American females, with more comorbid conditions, and an increased risk of surgical complications. Furthermore, presence of morbid obesity is associated with an increment in health care costs. Reducing obesity in the U.S population may not only decrease CRC incidence, but also improve these outcomes in patients admitted for CRC surgery.Table 1