Clinical Impact of Obesity on Postoperative Outcomes of Patients With Thyroid Cancer Undergoing Thyroidectomy: A 5-Year Retrospective Analysis From the US National Inpatient Sample

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-10-17 DOI:10.1002/cam4.70335

Yue Chen, Jiewen Jin, Pengyuan Zhang, Runyi Ye, Chuimian Zeng, Yilin Zhang, Junxin Chen, Hai Li, Haipeng Xiao, Yanbing Li, Hongyu Guan

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Abstract

Background

The clinical impact of obesity on postoperative outcomes of patients undergoing thyroidectomy remains controversial.

Methods

Patients aged ≥ 18 years who were diagnosed with thyroid malignancy and underwent thyroidectomy between 2016 and 2020 were included, and divided into two groups: patients with body mass index (BMI) < 30 kg/m² and those with BMI ≥ 30 kg/m². Patients in the obese group were then subdivided into four groups: Group 1 (BMI 30.0–34.9 kg/m²), Group 2 (BMI 35.0–39.9 kg/m²), Group 3 (BMI 40.0–44.9 kg/m²), and Group 4 (BMI ≥ 45.0 kg/m²) to evaluate the association between degree of obesity and clinical outcomes. We performed propensity score matching, compared outcome variables between the groups, and conducted adjusted multivariate logistic regression analyses of postoperative outcomes.

Results

A total of 6778 patients diagnosed with thyroid cancer who underwent thyroidectomy were screened, of whom 1299 (19.2%) patients were obese. Patients in the obese group had higher total hospital charges (p < 0.001) and an increased risk of overall postoperative complications (34.7% vs. 30.5%, p = 0.023). Specifically, patients in the obese group had increased odds of respiratory complication (adjusted odds ratio (aOR) 1.66, 95% confidence interval (CI) [1.26–2.19]), acute renal failure (aOR 1.87, 95% CI [1.13–3.09]), and wound complication (aOR 2.77, 95% CI [1.21–6.37]) than those in the non-obese group. Moreover, trend tests showed that the risks of unfavorable discharge, infection, acute renal failure, and respiratory complication all exhibited an upward trend with increased BMI.

Conclusion

Obesity is associated with an increased risk of postoperative complications in patients with thyroid cancer undergoing thyroidectomy. This finding suggests that obese patients should be treated with more caution during postoperative recovery.

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肥胖对接受甲状腺切除术的甲状腺癌患者术后结果的临床影响：来自美国全国住院患者样本的五年回顾性分析

背景肥胖对甲状腺切除术患者术后预后的临床影响仍存在争议。方法纳入2016年至2020年期间确诊为甲状腺恶性肿瘤并接受甲状腺切除术的年龄≥18岁的患者，并将其分为两组：体重指数（BMI）< 30 kg/m2的患者和体重指数≥30 kg/m2的患者。肥胖组患者又被细分为四组：第一组（BMI 30.0-34.9 kg/m2）、第二组（BMI 35.0-39.9 kg/m2）、第三组（BMI 40.0-44.9 kg/m2）和第四组（BMI ≥ 45.0 kg/m2），以评估肥胖程度与临床结果之间的关联。我们进行了倾向评分匹配，比较了各组间的结果变量，并对术后结果进行了调整后的多变量逻辑回归分析。结果共筛查了6778名接受甲状腺切除术的甲状腺癌患者，其中1299名（19.2%）患者为肥胖。肥胖组患者的住院总费用较高（p < 0.001），术后出现并发症的风险也较高（34.7% 对 30.5%，p = 0.023）。具体来说，与非肥胖组相比，肥胖组患者发生呼吸系统并发症（调整后几率比（aOR）1.66，95% 置信区间（CI）[1.26-2.19]）、急性肾功能衰竭（aOR 1.87，95% CI [1.13-3.09]）和伤口并发症（aOR 2.77，95% CI [1.21-6.37]）的几率更高。此外，趋势测试表明，出院不良、感染、急性肾功能衰竭和呼吸系统并发症的风险都随着体重指数的增加而呈上升趋势。结论肥胖与接受甲状腺切除术的甲状腺癌患者术后并发症风险增加有关。这一发现表明，肥胖患者在术后恢复期间应更加谨慎。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.