Obesity, Diabetes, and Smoking are Important Determinants of Resource Utilization in Liver Resection: A Multicenter Analysis of 1029 Patients

• DOI: 10.1097/sla.0b013e31819a032d
• Publication Date: 2009-05-21T10:21:00Z
• Authors: Roberto Gedaly; Patrick P. McHugh; Thomas D. Johnston; Hoonbae Jeon; Dinesh Ranjan; Daniel L. Davenport
• Keywords: Underweight

To investigate independent contributions of obesity, diabetes, and smoking to resource utilization in patients following liver resection.Despite being highly resource-intensive, resections are performed with increasing frequency. This study evaluates how potentially modifiable factors affect measures after hepatectomy.The American College Surgeons' National Surgical Quality Improvement Program (ACS NSQIP) public-use database was queried for undergoing resection. Resource variables were operative time (OT), intraoperative transfusion, length stay (LOS), ventilator support at 48 hours, reoperation. Bivariable multivariable linear logistic regressions performed.There 1029 identified. Most involved less than a hemiliver (599 patients, 58.2%). Mean BMI 28.0 +/- 6.0. OT 253 122 minutes (range, 27 794) but varied by procedure (P < 0.001). LOS 8.7 10.7 days 0 202). Morbid obesity added = 0.018), 1.1 units transfusions 0.049), 2.2 0.001), accounted delayed weaning (odds ratio, 4.5; P 0.022). Underweight had shorter OT, stayed 3.3 longer normal weight Insulin-treated diabetes increased 6.7; while orally-treated showed opposite trends. Smokers 1.9 risk prolonged ventilation 3.3; 0.002) reoperation 2.3; 0.015).Obesity, each associated important components healthcare expenditure. Education prevention programs needed limit their impact on overall utilization.