No evidence that obese people are at higher risk of complications after surgery

Results of a prospective study in this week's issue of THE LANCET suggest that excluding obese people from surgery because of fears about postoperative complications is unjustified.

Despite a lack of convincing evidence, obese people are thought to be at a higher risk of complications after surgery than those who are not obese. Pierre-Alain Clavien from Zurich's University Hospital, Switzerland, and colleagues prospectively investigated around 6300 patients undergoing general elective surgery. Postoperative illness was analysed for non-obese (body-mass index [BMI] less than 30 kilogrammes per metre squared) and obese patients (BMI greater than 30).

13% of the patients were obese, of whom 9% were severely obese (BMI greater than 35). With the exception of a small increase in the proportion of obese people who developed wound infection after open surgery, there was no difference in postoperative complications between obese and non-obese patients. Pierre-Alain Clavien comments: "Obesity alone is not a risk factor for postoperative complications. The regressive attitude towards general surgery in obese patients is no longer justified."

See also accompanying Commentary (p 2001)

Contact: Professor Pierre-Alain Clavien, Department of Visceral Surgery & Transplantation, University Hospital Zurich, Ramistrasse 100, CH-8091, Zurich, Switzerland,
T) 411-255-3300,
F) 411-255-4449;
E) clavien@chir.unizh.ch

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