Class 3 obesity is not associated with same-day admission in obese patients undergoing parathyroidectomy |
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| Institution: | 1. Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China;2. Department of Anesthesiology, Yancheng Third People''s Hospital, Yancheng, Jiangsu, China;3. Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China;4. Department of Anesthesiology, University of Utah Health, Salt Lake City, UT, USA;5. Transitional Residency Program, Intermountain Medical Center, Murray, UT, USA;6. Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, USA;4. Department of Recreation and Health-Care Management, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan;1. Department of Health Sciences, University of Milan, Milan, Italy;2. Department of Critical and Supportive Therapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;1. Icahn School of Medicine at Mount Sinai, New York, NY, United States of America;2. Department of Anesthesiology, Pain, and Perioperative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America |
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| Abstract: | ImportanceRising rates of obesity and outpatient performance of parathyroidectomies are making it increasingly crucial to investigate the association of obesity with post-operative complications.ObjectiveTo determine whether Class 3 obesity is associated with increased same-day admission compared to lower obesity classes following outpatient parathyroidectomy.DesignRetrospective cohort study.SettingOutpatient surgery.Patients12,973 patients ≥18 years old who underwent outpatient parathyroidectomy between 2014 and 2016, per the American College of Surgeons National Surgical Quality Improvement Program registry.InterventionsPrimary exposure variable: body mass index (BMI), with patients assigned to one of six cohorts.MeasurementsPrimary outcome measure: same-day admission. Secondary outcome measure: 30-day readmission. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI).Main resultsThere was a final sample size of 12,973 adult patients who underwent parathyroidectomy from 2014 to 2016. The admission rate for BMI ≥30 and < 40 kg/m2 (reference cohort) was 42.6%. The admission rates for Class 3 obesity categories were 46.2%, 56.2%, and 52.6% for those in the BMI range of ≥40 kg/m2 and < 50 kg/m2, ≥50 kg/m2 and < 60 kg/m2, and ≥ 60 kg/m2, respectively. On multivariable logistic regression, there were no difference in the odds of 30-day hospital admission or readmission rate with any of the BMI cohorts when compared to the reference group.ConclusionsThere is no significant difference in rates of same-day admission or 30-day readmission between any Class 3 (BMI ≥40 kg/m2) obesity cohort and the Class 1 and 2 (BMI ≥30 and < 40 kg/m2) reference cohort following outpatient parathyroidectomy. This corroborates the notion that BMI classes cannot be used in a vacuum to determine eligibility for outpatient parathyroidectomy – a concept that can guide safe and cost-effective institutional practices. |
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