Obesity Can Raise Odds for Post-Surgical Complications

By Steven Reinberg HealthDay Reporter

Weight gain can lead to serious complications following surgery.

A new study shows that obese patients are more likely to develop blood clots and infections after surgery than those of normal weight. These complications were more common in obese patients.

This is indicative of an obesity epidemic in the United States, said Dr. Robert Meguid. He is a professor of Cardiothoracic Surgery at the University of Colorado Aurora.

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Complications are increasing due to many factors. This includes inflammation of the body, which is common in obese patients. Patients who are obese or overweight may find it more difficult to move after surgery. This increases their risk of blood clots.

Meguid explained that fatty tissue is a problem with infection because it doesn't heal well and has a poorer blood flow than muscle tissue. The blood clots are caused by a combination of the inability to walk easily and quickly, as well as the inflammatory state of the body in obesity.

He added that changes in blood flow among obese patients may contribute to kidney failure.

Meguid added that obese patients may have more complications due to the difficulty of surgery.

He said that obese patients' operations are generally a bit more difficult. "I am a thoracic surgery, so I treat lung cancer and esophageal carcinoma in the chest. The operations for obese patients are more difficult."

Meguid said that patients who spend more time in the operating rooms are at greater risk of developing complications.

He said that patients get colder when they undergo surgery. "We know hypothermia, or the cold in the operating room, is associated with higher infection rates."

He said that patients with excess weight should be in the best possible physical condition before undergoing surgery. This includes refraining from smoking and drinking alcohol during the weeks leading up to surgery.

Meguid suggested that if the procedure was elective, it might be best to wait until the patient loses weight.

He advised that doctors caring for patients after surgery should be aware of the risks and watch out for blood clots, infections and kidney failure.

He added that doctors must also be open to discussing with patients how they can minimize their risk.

Meguid, his co-authors and themselves collected data from nearly 6,000,000 surgery patients in the United States. Of these, 45% of them were obese.

Nine surgical specialties were involved in the treatment of these patients, including gynecology and neurosurgery.

Patients with obesity had to wait a bit longer for their operations than patients who were normal weight -- median 89 minutes as opposed to 83 minutes. Median is the time taken by half of patients.

All those with obesity were at greater risk of infection, blood clots, and kidney complications.

The study found that, except for severely obese patients (body mass index > 40, compared with 18.5-24.9 for normal body weight), the odds of other post-surgical complications, including stroke, bleeding and lung problems, were not higher for obese patients than for the other patients.

Mitchell Roslin is the director of bariatric surgeries at Northern Westchester Hospital, Mount Kisco (N.Y.) and he said that obese patients have a body older than their actual age. He did not participate in the study, but he reviewed its findings.

Roslin explained that "the best way to explain it is that your biological and physiological ages are older than your chronological ages -- you have more miles on your speedometer."

Roslin said that patients with obesity were more likely to suffer from metabolic syndrome and high pressure, both of which can lead to kidney problems. He added that blood clots are caused by high blood pressure, blood vessel disease and increased inflammation.

Roslin said that the patient should be in good physical condition before surgery.

He said: "Obviously, get the surgery you need." "A healthy lifestyle is the most important thing. This means eating the correct amount of food, the right foods, and being physically active. Surgery is no different than anything else. The healthier you arrive, the better you will be when you leave.