Impact of Body Mass Index on Outcomes After Breast Cancer Surgery: Nationwide Inpatient Database Study in Japan.
Adolescent
Adult
Aged
Aged, 80 and over
Body Mass Index
Breast
/ pathology
Breast Neoplasms
/ complications
Breast Neoplasms, Male
/ complications
Databases, Factual
/ statistics & numerical data
Female
Hospital Costs
/ statistics & numerical data
Humans
Japan
/ epidemiology
Length of Stay
/ economics
Male
Mastectomy
/ adverse effects
Middle Aged
Neoplasm Staging
Obesity
/ complications
Patient Readmission
/ economics
Postoperative Complications
/ economics
Retrospective Studies
Risk Factors
Treatment Outcome
Young Adult
Body mass index
Breast-conserving surgery
Mastectomy
Obesity paradox
Short-term outcome
Journal
Clinical breast cancer
ISSN: 1938-0666
Titre abrégé: Clin Breast Cancer
Pays: United States
ID NLM: 100898731
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
22
03
2020
revised:
01
05
2020
accepted:
03
05
2020
pubmed:
18
8
2020
medline:
12
10
2021
entrez:
18
8
2020
Statut:
ppublish
Résumé
Recent studies have shown better postoperative outcomes in mildly obese patients, a phenomenon called the obesity paradox. In the field of breast cancer surgery, however, previous studies have only shown an association between obesity and worse postoperative outcomes using multivariable analysis; the obesity paradox has not been investigated in patients undergoing breast cancer surgery. We identified patients who underwent mastectomy for stage 0 to III breast cancer from July 2010 to March 2017 using a Japanese nationwide inpatient database. We used restricted cubic spline analyses to investigate potential nonlinear associations between body mass index (BMI) and outcomes (postoperative complications, 30-day readmission, duration of anesthesia, length of hospital stay, and hospitalization costs). We also performed multivariable regression analyses for the outcomes. Among 239,108 eligible patients, 25.6% had a BMI of > 25.0 kg/m Restricted cubic spline analyses displayed U-shaped associations between BMI and in-hospital complications, length of stay, and hospitalization costs, but none of the associations showed the obesity paradox.
Sections du résumé
BACKGROUND
Recent studies have shown better postoperative outcomes in mildly obese patients, a phenomenon called the obesity paradox. In the field of breast cancer surgery, however, previous studies have only shown an association between obesity and worse postoperative outcomes using multivariable analysis; the obesity paradox has not been investigated in patients undergoing breast cancer surgery.
PATIENTS AND METHODS
We identified patients who underwent mastectomy for stage 0 to III breast cancer from July 2010 to March 2017 using a Japanese nationwide inpatient database. We used restricted cubic spline analyses to investigate potential nonlinear associations between body mass index (BMI) and outcomes (postoperative complications, 30-day readmission, duration of anesthesia, length of hospital stay, and hospitalization costs). We also performed multivariable regression analyses for the outcomes.
RESULTS
Among 239,108 eligible patients, 25.6% had a BMI of > 25.0 kg/m
CONCLUSION
Restricted cubic spline analyses displayed U-shaped associations between BMI and in-hospital complications, length of stay, and hospitalization costs, but none of the associations showed the obesity paradox.
Identifiants
pubmed: 32800491
pii: S1526-8209(20)30094-X
doi: 10.1016/j.clbc.2020.05.002
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e663-e674Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.