scholarly journals The clinical research office of the endourological society percutaneous nephrolithotomy global study: Outcomes in the morbidly obese patient – a case control analysis

2014 ◽  
Vol 8 (5-6) ◽  
pp. 393 ◽  
Author(s):  
Andrew Fuller ◽  
Hassan Razvi ◽  
John D. Denstedt ◽  
Linda Nott ◽  
Ad Hendrikx ◽  
...  
Keyword(s):  
Clinical Research ◽  
Percutaneous Nephrolithotomy ◽  
Normal Weight ◽  
Obese Group ◽  
Morbidly Obese ◽  
Transfusion Rate ◽  
Control Analysis ◽  
Obese Patients ◽  
Operative Duration ◽  
Research Office

Background: Efficacy and safety of percutaneous nephrolithotomy (PCNL) have been demonstrated in obese individuals. Yet, there is a paucity of data on the outcomes of PCNL in morbidly obese patients (body mass index [BMI] >40).Methods: Perioperative and stone-related outcomes following PCNL in morbidly obese patients was assessed using a prospective database administered by the Clinical Research Office of the Endourological Society (CROES). A multidimensional match of 97 morbidly obese patients with those of normal weight was created using propensity score matching. Student’s t-test and Chi-square tests were used to assess for differences between the groups.Results: In total, 97 patients with a BMI >40 kg/m2 were matched by stone characteristics with 97 patients of normal weight. The morbidly obese population demonstrated higher rates of diabetes mellitus (43% vs. 6%, p < 0.001) and cardiovascular disease (56% vs. 18%, (p < 0.001). Access was achieved more frequently by radiologists in the morbidly obese group (19% vs. 6%, p = 0.016). Mean operative duration was longer in the morbidly obese group (112 ± 56 min vs. 86 ± 43.5 min, p < 0.001). Stone-free rates were lower in the morbidly obese group (66% vs. 77%, p = 0.071). There was no significant difference in length of hospital stay or transfusion rate. Morbidly obese patients were significantly more likely to experience a postoperative complication (22% vs. 6%, p = 0.004).Interpretation: PCNL in morbidly obese patients is associated with longer operative duration, higher rates of re-intervention and an increased risk of perioperative complications. With this knowledge, urologists should seek to develop strategies to optimize the perioperative management of such patients.

The effect of BMI on systemic toxicity in AML patients receiving chemotherapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7108-7108
Author(s):  
Manish J. Dave ◽  
Mansoor Burhani ◽  
Parameswaran Venugopal ◽  
Melissa L. Larson
Keyword(s):  
Induction Chemotherapy ◽  
Normal Weight ◽  
Systemic Toxicity ◽  
Obese Group ◽  
World Health ◽  
Morbidly Obese ◽  
Obese Patients ◽  
The Us ◽  
The Mean ◽  
Platelet Transfusions

7108 Background: There are about 15,000 new cases of acute myeloid leukemia (AML) every year in the US, and about 9,000 will die annually from this disease. Because approximately 69.2% of adults in the US are overweight or obese, it is important to examine whether body mass index (BMI) can affect treatment outcomes. While there has been a study of survival based on BMI, there have been no studies to examine the effect of BMI on systemic toxicity with induction chemotherapy. Methods: 91 patients with AML were treated with a high-dose cytarabine and mitoxantrone regimen from 2008-2012. Prior to receiving induction chemotherapy, each patient’s BMI was recorded. All patients in this study were treated with doses based on actual weight. Two doses of cytarabine 3 gm/m2 were given 12 hours apart followed by one dose of mitoxantrone 30 mg/m2on days 1 and 5. The lowest platelet and hemoglobin after each induction treatment was recorded, along with the number of red blood cell (RBC) and platelet transfusions. Systemic toxicity was further examined by presence of infection and/or bleeding. Results: The BMI groups are based on the World Health Organization classifications. Of the 91 AML patients in this study, 2 were underweight, 35 were normal weight, 29 were overweight, 16 were obese, and 9 were morbidly obese. The mean number of platelet transfusions for the underweight group was 8.5, 10.6 for normal weight, 13.8 for overweight, 12.1 for obese, and 5.0 for the morbidly obese group. The mean number of RBC transfusions for the underweight group was 6.0, 9.1 for normal weight, 11.2 for overweight, 9.1 for obese, and 9.2 for the morbidly obese group. The rates of infection by positive cultures were the following: 51% of normal, 58% of overweight, and 68% of obese patients. Rates of infection by imaging were 37% of normal, 31% of overweight, and 26% of morbidly obese patients. The percentage of patients bleeding after induction was 20% in the normal weight group, 31% for overweight, 12.5% of obese, and 33% of morbidly obese patients. Conclusions: The results of this study show that there is no difference in toxicity amongst the different BMI groups. The data demonstrates the importance of dosing chemotherapy on actual, rather than ideal, body weight.

scholarly journals The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: Nephrolithotomy in 189 Patients with Solitary Kidneys

2012 ◽  
Vol 26 (4) ◽  
pp. 336-341 ◽  
Author(s):  
Viorel Bucuras ◽  
Ganesh Gopalakrishnam ◽  
J. Stuart Wolf ◽  
Yinghao Sun ◽  
Giampaolo Bianchi ◽  
...  
Keyword(s):  
Clinical Research ◽  
Percutaneous Nephrolithotomy ◽  
Global Study ◽  
Research Office

scholarly journals Impact of weight on stone-free rate during percutaneous nephrolithotomy

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Abdrabuh M. Abdrabuh
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Operative Procedure ◽  
World Health ◽  
Fluoroscopy Time ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Co Morbidity ◽  
Stone Free Rate ◽  
Morbid Obese ◽  
Free Rate

Abstract Background To assess Impact of weight on stone-free rate during percutaneous nephrolithotomy. Methods Hundred and twenty-three PNL procedures were done between January 2016 and July 2017. The patients were divided into four groups according to the World Health Organization (WHO) classification of body mass index (BMI): < 25 ((group 1, average)), 25–29.9 (group 2, overweight), 30–39.9 (group 3, obese), and ≥ 40 kg/m2 (group 4, morbidly obese). All groups were compared as regarding preoperative variables, intra-operative procedure and postoperative results. Results The non-obese groups were younger in age than obese and morbid obese groups (P = 0.005). The difference in BMI was statistically significant between non-obese and obese groups (P = 0.0001). Most of females gender were obese and morbid obese (P = 0.0001) and most of the obese patients had left-sided renal stone (P = 0.001). Most of overweight and obese groups had radiopaque stones (P = 0.02). There were no statistically significant differences between all groups as regarding co-morbidity, stone size, stone locations, and hydronephrosis grade. Operative time (P = 0.034), length of hospital stay (P value = 0.014) and fluoroscopy time (P = 0.0001) were statistically significant differences between all groups. Number of accesses, access site, postoperative hemoglobin drop, post- operative complications, fate of residual stones and stone-free rate were not statistically significant differences between all groups. BMI was correlated with mean fluoroscopy time and mean hospitalization duration in our study as the time of hospitalization and time of x-ray exposure increase with obesity. Conclusion PNL is a safe and effective procedure for obese patients. BMI do not predict clearance post PNL.

scholarly journals Lithotrites and Postoperative Fever: Does Lithotrite Type Matter? Results from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study

2013 ◽  
Vol 91 (3) ◽  
pp. 340-344 ◽  
Author(s):  
David I. Chu ◽  
Michael E. Lipkin ◽  
Agnes J. Wang ◽  
Michael N. Ferrandino ◽  
Glenn M. Preminger ◽  
...  
Keyword(s):  
Clinical Research ◽  
Percutaneous Nephrolithotomy ◽  
Postoperative Fever ◽  
Global Study ◽  
Research Office

Appendicitis, Body Mass Index, and CT: Is CT More Valuable for Obese Patients than Thin Patients?

2011 ◽  
Vol 77 (4) ◽  
pp. 471-475 ◽  
Author(s):  
Courtney A. Coursey ◽  
Rendon C. Nelson ◽  
Ricardo D. Moreno ◽  
Mayur B. Patel ◽  
Craig A. Beam ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Normal Weight ◽  
Morbidly Obese ◽  
Negative Appendectomy ◽  
Obese Patients ◽  
Procedure Code ◽  
Preoperative Ct ◽  
The Difference ◽  
Underweight Patients

The purpose of our study is to determine whether body mass index (BMI = weight in kg/height in meters2) was related to the rate of negative appendectomy in patients who underwent preoperative CT. A surgical database search performed using the procedure code for appendectomy identified 925 patients at least 18 years of age who underwent urgent appendectomy between January 1998 and September 2007. BMI was computed for the 703 of these 925 patients for whom height and weight information was available. Patients were stratified based on body mass index (BMI 15-18.49 = underweight; 18.5-24.9 = normal weight; 25–29.9 = overweight; 30-39.9 = obese; > 40 = morbidly obese). Negative appendectomy rates were computed. Negative appendectomy rates for patients who did and did not undergo preoperative CT were 27 per cent and 50 per cent for underweight patients, 10 per cent and 15 per cent for normal weight patients, 12 per cent and 17 per cent for overweight patients, 7 per cent and 30 per cent for obese patients, and 10 per cent and 100 per cent for morbidly obese patients. The difference in negative appendectomy rates for overweight patients, obese patients, and morbidly obese patients who underwent preoperative CT as compared with patients in the same BMI category who did not undergo preoperative CT was statistically significant ( P ≤ 0.001). The negative appendectomy rates for overweight patients, obese patients, and morbidly obese patients who underwent preoperative CT were significantly lower than for patients in these same BMI categories who did not undergo preoperative CT.

scholarly journals Impact of body mass on hospital resource use in total hip arthroplasty

2009 ◽  
Vol 12 (8) ◽  
pp. 1122-1132 ◽  
Author(s):  
John A Batsis ◽  
James M Naessens ◽  
Mark T Keegan ◽  
Amy E Wagie ◽  
Paul M Huddleston ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Resource Utilization ◽  
Hip Arthroplasty ◽  
Tertiary Care ◽  
Obese Group ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Total Hip ◽  
Operative Costs ◽  
The Impact

AbstractObjectiveTo determine the impact of BMI on post-operative outcomes and resource utilization following elective total hip arthroplasty (THA).DesignA retrospective cohort analysis on all primary elective THA patients between 1996 and 2004. Primary outcomes investigated using regression analyses included length of stay (LOS) and costs (US dollars).SettingMayo Clinic Rochester, a tertiary care centre.SubjectsPatients were stratified by pre-operative BMI as normal (18·5–24·9 kg/m2), overweight (25·0–29·9 kg/m2), obese (30·0–34·9 kg/m2) and morbidly obese (≥35·0 kg/m2). Of 5642 patients, 1362 (24·1 %) patients had a normal BMI, 2146 (38·0 %) were overweight, 1342 (23·8 %) were obese and 792 (14·0 %) were morbidly obese.ResultsAdjusted LOS was similar among normal (4·99 d), overweight (5·00 d), obese (5·02 d) and morbidly obese (5·17 d) patients (P= 0·20). Adjusted overall episode costs were no different (P= 0·23) between the groups of normal ($17 211), overweight ($17 462), obese ($17 195) and morbidly obese ($17 655) patients. Overall operative and anaesthesia costs were higher in the morbidly obese group ($5688) than in normal ($5553), overweight ($5549) and obese ($5593) patients (P= 0·03). Operating room costs were higher in morbidly obese patients ($3418) than in normal ($3276), overweight ($3291) and obese ($3340) patients (P< 0·001). Post-operative costs were no different (P= 0·30). Blood bank costs differed (P= 0·002) and were lower in the morbidly obese group ($180) compared with the other patient groups (P< 0·05). Other differences in costs were not significant. Morbidly obese patients were more likely to be transferred to a nursing home (24·1 %) than normal (18·4 %), overweight (17·9 %) or obese (16·0 %) patients (P= 0·001 each). There were no differences in the composite endpoint of 30 d mortality, re-admissions, re-operations or intensive care unit utilization.ConclusionsBMI in patients undergoing primary elective THA did not impact LOS or overall institutional acute care costs, despite higher operative costs in morbidly obese patients. Obesity does not increase resource utilization for elective THA.

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