BACKGROUND: Crohn's disease (CD) patients are typically underweight; however, a growing cohort of overweight CD patients is emerging. The current study investigates whether body mass index (BMI) or volumetric fat parameters can be used to predict morbidity after ileocolectomy for CD. METHODS: One hundred and forty-three CD patients who underwent elective ileocolectomy were identified from our Inflammatory Bowel Disease (IBD) Registry. Patient demographics and operative outcomes were recorded. Visceral (VA) and subcutaneous (SA) adiposity and abdominal circumference (AC) were analyzed on preoperative CT scans using Aquarius iNtuition software. A visceral/subcutaneous ratio (VSR) was calculated. RESULTS: BMI correlated with SA (p = 0.0001), VA (p = 0.0001) and AC (p = 0.0001) but not VSR (p > 0.05). BMI, VA and AC did not predict surgical morbidity (p > 0.05). In multivariate regression analysis, family history of IBD (p = 0.009), high American Society of Anesthesiologists score (p = 0.02) and increased VSR (p = 0.03) were independent predictors of postoperative morbidity. CONCLUSIONS: The visceral/subcutaneous fat ratio is a more reliable predictor of postoperative outcomes in CD patients undergoing ileocolectomy than conventional adiposity markers such as BMI. Preoperative calculation of the visceral/subcutaneous fat ratio offers the opportunity to optimize high-risk surgical patients, thus improving outcomes.
BACKGROUND:Crohn's disease (CD) patients are typically underweight; however, a growing cohort of overweight CDpatients is emerging. The current study investigates whether body mass index (BMI) or volumetric fat parameters can be used to predict morbidity after ileocolectomy for CD. METHODS: One hundred and forty-three CDpatients who underwent elective ileocolectomy were identified from our Inflammatory Bowel Disease (IBD) Registry. Patient demographics and operative outcomes were recorded. Visceral (VA) and subcutaneous (SA) adiposity and abdominal circumference (AC) were analyzed on preoperative CT scans using Aquarius iNtuition software. A visceral/subcutaneous ratio (VSR) was calculated. RESULTS: BMI correlated with SA (p = 0.0001), VA (p = 0.0001) and AC (p = 0.0001) but not VSR (p > 0.05). BMI, VA and AC did not predict surgical morbidity (p > 0.05). In multivariate regression analysis, family history of IBD (p = 0.009), high American Society of Anesthesiologists score (p = 0.02) and increased VSR (p = 0.03) were independent predictors of postoperative morbidity. CONCLUSIONS: The visceral/subcutaneous fat ratio is a more reliable predictor of postoperative outcomes in CDpatients undergoing ileocolectomy than conventional adiposity markers such as BMI. Preoperative calculation of the visceral/subcutaneous fat ratio offers the opportunity to optimize high-risk surgical patients, thus improving outcomes.
Authors: Kimberley W J Van Der Sloot; Amit D Joshi; Danielle R Bellavance; Katherine K Gilpin; Kathleen O Stewart; Paul Lochhead; John J Garber; Cosmas Giallourakis; Vijay Yajnik; Ashwin N Ananthakrishnan; Behrooz Z Alizadeh; Ramnik J Xavier; Hamed Khalili Journal: Inflamm Bowel Dis Date: 2017-01 Impact factor: 5.325
Authors: Stephan C Bischoff; Rocco Barazzoni; Luca Busetto; Marjo Campmans-Kuijpers; Vincenzo Cardinale; Irit Chermesh; Ahad Eshraghian; Haluk Tarik Kani; Wafaa Khannoussi; Laurence Lacaze; Miguel Léon-Sanz; Juan M Mendive; Michael W Müller; Johann Ockenga; Frank Tacke; Anders Thorell; Darija Vranesic Bender; Arved Weimann; Cristina Cuerda Journal: United European Gastroenterol J Date: 2022-08-12 Impact factor: 6.866
Authors: Michiel T J Bak; Marit F E Ruiterkamp; Oddeke van Ruler; Marjo J E Campmans-Kuijpers; Bart C Bongers; Nico L U van Meeteren; C Janneke van der Woude; Laurents P S Stassen; Annemarie C de Vries Journal: World J Gastroenterol Date: 2022-06-14 Impact factor: 5.374
Authors: Nik Sheng Ding; Daniel Tassone; Ibrahim Al Bakir; Kyle Wu; Alexander J Thompson; William R Connell; George Malietzis; Phillip Lung; Siddharth Singh; Chang-Ho Ryan Choi; Simon Gabe; John T Jenkins; Ailsa Hart Journal: J Crohns Colitis Date: 2022-09-08 Impact factor: 10.020