Body mass index is not associated with reoperation rates in patients with a surgically treated perforated peptic ulcer

INTRODUCTION: The aim of the present nationwide Danish cohort study was to examine the association between body mass index (BMI) and reoperation in patients who are sur-gically treated for perforated peptic ulcer (PPU).

METHODS: This was a nationwide cohort study of all Danish patients who were surgically treated for benign gastric or duodenal PPU between 2011 and 2013.

OUTCOME MEASURES: reoperation within 30 days of the primary surgical procedure and 90-day survival. The association between BMI and reoperation are presented as crude and adjusted odds ratios (OR) with 95% confidence intervals (CIs).

RESULTS: A total of 726 patients were included. The median age was 69.5 years (range: 18.2-101.7 years), 51.4% were women (n = 373), 78.4% (n = 569) of the patients had at least one co-existing disease, and 47.5% (n = 345) were categorised as American Society of Anesthesiologists (ASA) class ≥ 3. Re-operative surgery was done in 124 patients (17.1%). No statistically significant adjusted association between underweight, overweight or obesity and re-operation was found (adjusted OR (95% CI): 0.456 (0.181-1.148), 1.468 (0.857-2.517), and 1.314 (0.663-2.601), respectively). Patients undergoing reoperative surgery had a statistically significantly lower crude 90-day survival than patients without need of reperative surgery; 63.9% (83/124) versus 75.9% (457/602), p = 0.037.

CONCLUSION: In the present nationwide cohort study of PPU patients, no statistically significantly adjusted correlation between BMI and re-operation rates was found. Patients undergoing reoperative surgery had a decreased 90-day survival.

FUNDING: not relevant.

TRIAL REGISTRATION: not relevant.