TY - JOUR
T1 - The impact of body mass index on surgical complications in minimally invasive hysterectomy for uterine fibroids
AU - Axelrod, Michal
AU - Hamilton, Kacey M.
AU - Schneyer, Rebecca J.
AU - Levin, Gabriel
AU - Weiss, Yotam
AU - Siedhoff, Matthew T.
AU - Wright, Kelly N.
AU - Meyer, Raanan
N1 - Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2025/2
Y1 - 2025/2
N2 - Research question: We aimed to assess the impact of Body Mass Index (BMI) on 30-day postoperative complications in patients undergoing minimally invasive hysterectomy (MIH) for fibroids. Design: Using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2012–2020), we analyzed major and minor 30-day postoperative complications, stratified by BMI, in patients with uterine fibroids who underwent MIH. Complications were stratified according to the Clavien-Dindo classification. Results: Among 61,192 patients, overall complication rates ranged from 6.3 % to 8.1 %, with the highest rates in obesity class 3. Significant differences were observed in minor complication rates across BMI groups, though major complication rates did not significantly vary. Higher BMI classes correlated with longer operative times, with mean durations ranging from 127.1 min in the lowest BMI group to 158.1 min in the highest BMI group (p < 0.001). In multivariable regression, higher BMI was associated with increased odds of minor complications [</≥34.5 kg/m2, aOR 95 % CI = 1.10 (1.01–1.21)]. There was no significant association between lower and higher BMI (</≥32.8 kg/m2) and major complications. Additionally, overweight, obesity class 2 and 3 were independently associated with lower odds of major complications [aOR 95 % CI 0.82 (0.71–0.94), 0.77 (0.64–0.92) and 0.82 (0.67–1.00), respectively], compared to the normal BMI group. BMI categories were not independently associated with any or minor complications compared to normal the normal BMI category. Conclusion: After adjusting for confounding factors, overweight, obesity class 2 and 3 are associated with a decreased risk of major complications compared to normal BMI. In contrast, BMI categories were not associated with any- or minor complications. Higher BMI classes were associated with longer operative times.
AB - Research question: We aimed to assess the impact of Body Mass Index (BMI) on 30-day postoperative complications in patients undergoing minimally invasive hysterectomy (MIH) for fibroids. Design: Using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2012–2020), we analyzed major and minor 30-day postoperative complications, stratified by BMI, in patients with uterine fibroids who underwent MIH. Complications were stratified according to the Clavien-Dindo classification. Results: Among 61,192 patients, overall complication rates ranged from 6.3 % to 8.1 %, with the highest rates in obesity class 3. Significant differences were observed in minor complication rates across BMI groups, though major complication rates did not significantly vary. Higher BMI classes correlated with longer operative times, with mean durations ranging from 127.1 min in the lowest BMI group to 158.1 min in the highest BMI group (p < 0.001). In multivariable regression, higher BMI was associated with increased odds of minor complications [</≥34.5 kg/m2, aOR 95 % CI = 1.10 (1.01–1.21)]. There was no significant association between lower and higher BMI (</≥32.8 kg/m2) and major complications. Additionally, overweight, obesity class 2 and 3 were independently associated with lower odds of major complications [aOR 95 % CI 0.82 (0.71–0.94), 0.77 (0.64–0.92) and 0.82 (0.67–1.00), respectively], compared to the normal BMI group. BMI categories were not independently associated with any or minor complications compared to normal the normal BMI category. Conclusion: After adjusting for confounding factors, overweight, obesity class 2 and 3 are associated with a decreased risk of major complications compared to normal BMI. In contrast, BMI categories were not associated with any- or minor complications. Higher BMI classes were associated with longer operative times.
KW - body mass index (BMI)
KW - Minimally invasive hysterectomy (MIH)
KW - Myoma
KW - Obesity paradox
KW - Postoperative complications
KW - Uterine fibroids
UR - http://www.scopus.com/inward/record.url?scp=85213971865&partnerID=8YFLogxK
U2 - 10.1016/j.ejogrb.2024.12.047
DO - 10.1016/j.ejogrb.2024.12.047
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C2 - 39756341
AN - SCOPUS:85213971865
SN - 0301-2115
VL - 305
SP - 387
EP - 393
JO - European Journal of Obstetrics and Gynecology and Reproductive Biology
JF - European Journal of Obstetrics and Gynecology and Reproductive Biology
ER -