Do obese patients have a higher risk of infection and dying after colon surgery? In a study published in the August issue of Diseases of the Colon & Rectum, investigators from the University of Alabama at Birmingham sought to answer this question.

While it has been long recognized that heavy patients are at higher risk of complications after surgery, Dr. Wahl and his colleagues wanted to find out whether there was a difference whether a patient was merely pudgy or downright obese.

The authors used a large database, the 2011 to 2013 American College of Surgeons National Surgical Quality Improvement database and evaluated over the 74,000 patients undergoing colorectal surgery. Among these, approximately 4% were underweight (defined as having a body mass index [BMI] < 18.5), 29 % were normal weight (BMI: 18.5-24.9), 33% were overweight (BMI: 25-29.9), 20% were obesity class I (30-34.9), 8% obesity class II (BMI: 35-39.9) and 6% to obesity class III (> 40 BMI).

Compared with normal weight patients, the chance of getting a wound infection after surgery increased with each increasing class of obesity. In other words, patients in obesity class I were one and a half times more likely to get a wound infection, while those in obesity class III were twice as likely to get a wound infection compared to normal weight patients.

In addition, very obese patients (obesity class III) were more likely to have severe infections, pneumonias, urinary tract infections, and to rupture their abdominal incisions compared to normal weight patients. The risk of death after surgery was also highest in this group.

With the significant increase in overweight patients in our country, the findings of this study have significant financial implications for our health care system. For potential patients who may be undergoing surgery, this is one more way you can make surgery safer…by keeping off those extra pounds.