Association of Preoperative Body Mass Index with Surgical Textbook Outcomes Following Hepatectomy for Hepatocellular Carcinoma: A Multicenter Study of 1206 Patients

作者：Liu, Zhi-Peng; Yao, Lan-Qing; Diao, Yong-Kang; Chen, Zi-Xiang; Feng, Zi-Han; Gu, Wei-Min; Chen, Zheng-Liang; Chen, Ting-Hao; Zhou, Ya-Hao; Wang, Hong; Xu, Xin-Fei; Wang, Ming-Da; Li, Chao; Liang, Lei; Zhang, Cheng-Wu; Pawlik, Timothy M.; Lau, Wan Yee; Shen, Feng; Chen, Zhi-Yu^*; Yang, Tian^*

来源：Annals of Surgical Oncology, 2022, 29(7): 4278-4286.

DOI：10.1245/s10434-022-11721-y

• PERIOPERATIVE BLOOD-TRANSFUSION
• LIVER RESECTION
• COMPOSITE-MEASURE
• SURGERY
• COMPLICATIONS
• CANCER
• CARE

Background Assessment of quality in the perioperative period is critical to ensure good patient care. Textbook outcomes (TO) have been proposed to combine several parameters into a single defined quality metric. The association of preoperative body mass index (BMI) with incidences of achieving or not achieving TO (non-TO) among patients undergoing hepatectomy for hepatocellular carcinoma (HCC) was characterized. Methods Patients who underwent curative-intent hepatectomy for HCC between 2015 and 2018 were identified from a multicenter database. These patients were divided into three groups based on preoperative BMI: low-BMI (<= 18.4 kg/m(2)), normal-BMI (18.5-24.9 kg/m(2)), and high-BMI (>= 25.0 kg/m(2)). The incidences of non-TO among these three groups were compared. Multivariate analyses were performed to identify whether there was any independent association between preoperative BMI and non-TO. Results Among 1206 patients, 100 (8.3%), 660 (54.7%), and 446 (37.0%) were in the low-BMI, normal-BMI, and high-BMI groups, respectively. The incidence of non-TO was 65.6% in the whole cohort. The incidence of non-TO was significantly higher among patients in the low- and high-BMI cohorts versus the normal-BMI cohort (75.0% and 74.7% versus 58.0%, both P < 0.01). After adjustment of other confounding factors on multivariate analysis, low-BMI and high-BMI were independently associated with higher incidences of non-TO compared with normal-BMI (OR: 1.98 and 2.27, both P < 0.05). Conclusions Two out of three patients did not achieve TO after hepatectomy for HCC. Both preoperative low-BMI and high-BMI were independently associated with lower odds to achieve optimal TO following HCC resection.

• 单位
  南通大学; 1; 哈尔滨医科大学; 安徽医科大学