J Obes Metab Syndr.  2021 Dec;30(4):377-385. 10.7570/jomes21057.

Short-term Mortality and Postoperative Complications of Abdominal Aortic Aneurysm Repair in Obese versus Non-obese Patients

• Zonneveld B
• Vu D
• Kardys I
• Dalen BMv
• Snelder SM

• KMID: 2524577
• DOI: http://doi.org/10.7570/jomes21057

Abstract

Background
Obesity is a risk factor not only for abdominal aortic aneurysm (AAA) but also for complications after vascular surgery. This study was to determine the effect of obesity on short-term mortality and post-intervention complications after AAA repair.
Methods
A systematic review and meta-analysis were performed. A systematic search was performed in PubMed; the articles describing the differences in post-intervention complications after open or endovascular repair of an AAA between obese and non-obese patients were selected. The primary outcome was short-term mortality defined as in-hospital mortality or mortality within 30 days after AAA repair. The secondary outcomes were cardiac complications, pulmonary failure, renal failure, and wound infections. The meta-analysis was performed using OpenMeta.
Results
Four articles were included in the meta-analysis; these articles included 35,989 patients of which 10,917 (30.3%) were obese. The meta-analysis showed no significant differences for short-term mortality (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.69–1.04). Also, no significant difference was found in pulmonary failure (OR, 1.09; 95% CI, 0.85–1.42). However, obese patients were less likely to suffer from cardiac complications (OR, 0.73; 95% CI, 0.55–0.96). Nevertheless, there was a significantly higher risk of renal failure (OR, 1.16; 95% CI, 1.05–1.30) and wound infections (OR, 1.92; 95% CI, 1.55–2.38) in obese patients.
Conclusion
Obesity is not a risk factor for short-term mortality after AAA repair compared to non-obesity. Moreover, obese patients suffer less from cardiac complications than non-obese patients.

Keyword

Obesity; Abdominal aortic aneurysm; Postoperative complications; Mortality