1
|
Liu Y, Hu H, Han Y, Li L, Li Z, Zhang L, Luo Z, Huang G, Lan Z. Body Mass Index Has a Nonlinear Association With Postoperative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors in Men: An Analysis of Data From the ACS NSQIP Database. Front Endocrinol (Lausanne) 2022; 13:868968. [PMID: 35518931 PMCID: PMC9065251 DOI: 10.3389/fendo.2022.868968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The association between body mass index (BMI) and mortality is controversial. Thus, the purpose of our research was to survey the association between BMI and postoperative 30-day mortality in brain tumor patients undergoing craniotomy. METHODS This study analyzed data collected in a multicenter, cross-sectional study that consecutively and nonselectively collected data from a total of 18,642 patients undergoing craniotomy for tumors in the ACS NSQIP from 2012 to 2015. We constructed three linear and non-linear binomial logistic models (the inflection point was set at 18.5) to evaluate the association between BMI and postoperative 30-day mortality, respectively. We also conducted subgroup analyses. Additionally, we compared non-linear models with vs. without interaction with sex. RESULTS A total of 17,713 patients were included in this analysis. Of these, 47.38% were male. The postoperative 30-day mortality of the included cases was 2.39% (423/17,713), and the mean BMI was 28.41 ± 6.05 kg/m2. The linear logistic models suggested that after adjusting for the covariates, BMI was not associated with postoperative 30-day mortality (OR=0.999; 95% CI: 0.981, 1.017). The non-linear binomial logistic models suggested a nonlinear relationship between BMI and postoperative 30-day mortality. When BMI was < 18.5, we observed a stronger negative association between them after adjusting for covariates; the OR and 95% CI were 0.719, 0.576-0.896. When BMI was > 18.5, the relationship between them was not significant. We also found that a one-unit decrease in BMI for male patients with BMI < 18.5 kg/m2 was related to a 34.6% increase in the risk of postoperative 30-day mortality (OR=0.654, 95% CI (0.472, 0.907). There was no significant association between them in male patients with BMI > 18.5 kg/m2 or female patients. CONCLUSIONS This study demonstrates a non-linear relationship between BMI and the risk of postoperative death. Preoperative underweight (BMI < 18.5 kg/m2) would increase the risk of postoperative death in male patients (> 18 years old) undergoing craniotomy for brain tumors. Appropriate nutritional management prior to craniotomy for brain tumors may reduce the risk of postoperative 30-day mortality in underweight men.
Collapse
Affiliation(s)
- Yufei Liu
- Neurosurgical Department, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Shenzhen University Health Science Center, Shenzhen, China
| | - Haofei Hu
- Shenzhen University Health Science Center, Shenzhen, China
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Yong Han
- Shenzhen University Health Science Center, Shenzhen, China
- Department of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Lunzou Li
- Neurosurgical Department, Hechi People’s Hospital, Hechi, China
| | - Zongyang Li
- Neurosurgical Department, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
- Shenzhen University Health Science Center, Shenzhen, China
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhu Luo
- Neurosurgical Department, Hechi People’s Hospital, Hechi, China
- *Correspondence: Zhu Luo, ; Guodong Huang, ; Zhan Lan,
| | - Guodong Huang
- Neurosurgical Department, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
- Shenzhen University Health Science Center, Shenzhen, China
- *Correspondence: Zhu Luo, ; Guodong Huang, ; Zhan Lan,
| | - Zhan Lan
- Neurosurgical Department, Hechi People’s Hospital, Hechi, China
- *Correspondence: Zhu Luo, ; Guodong Huang, ; Zhan Lan,
| |
Collapse
|