Volumetric fat ratio and not body mass index is predictive of ileocolectomy outcomes in Crohn's disease patients

Tara M. Connelly, Ryan M. Juza, William Sangster, Rishabh Sehgal, Rafel F. Tappouni, Evangelos Messaris

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)219-224
Number of pages6
JournalDigestive Surgery
Volume31
Issue number3
DOIs
StatePublished - Nov 7 2014

Fingerprint

Crohn Disease
Body Mass Index
Fats
Intra-Abdominal Fat
Subcutaneous Fat
Adiposity
Morbidity
Inflammatory Bowel Diseases
Intuition
Thinness
Registries
Software
Multivariate Analysis
Regression Analysis
Demography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

Connelly, T. M., Juza, R. M., Sangster, W., Sehgal, R., Tappouni, R. F., & Messaris, E. (2014). Volumetric fat ratio and not body mass index is predictive of ileocolectomy outcomes in Crohn's disease patients. Digestive Surgery, 31(3), 219-224. https://doi.org/10.1159/000365359
Connelly, Tara M. ; Juza, Ryan M. ; Sangster, William ; Sehgal, Rishabh ; Tappouni, Rafel F. ; Messaris, Evangelos. / Volumetric fat ratio and not body mass index is predictive of ileocolectomy outcomes in Crohn's disease patients. In: Digestive Surgery. 2014 ; Vol. 31, No. 3. pp. 219-224.
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Connelly, TM, Juza, RM, Sangster, W, Sehgal, R, Tappouni, RF & Messaris, E 2014, 'Volumetric fat ratio and not body mass index is predictive of ileocolectomy outcomes in Crohn's disease patients', Digestive Surgery, vol. 31, no. 3, pp. 219-224. https://doi.org/10.1159/000365359

Volumetric fat ratio and not body mass index is predictive of ileocolectomy outcomes in Crohn's disease patients. / Connelly, Tara M.; Juza, Ryan M.; Sangster, William; Sehgal, Rishabh; Tappouni, Rafel F.; Messaris, Evangelos.

In: Digestive Surgery, Vol. 31, No. 3, 07.11.2014, p. 219-224.

Research output: Contribution to journalArticle

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T1 - Volumetric fat ratio and not body mass index is predictive of ileocolectomy outcomes in Crohn's disease patients

AU - Connelly, Tara M.

AU - Juza, Ryan M.

AU - Sangster, William

AU - Sehgal, Rishabh

AU - Tappouni, Rafel F.

AU - Messaris, Evangelos

PY - 2014/11/7

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N2 - 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.

AB - 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.

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