Obesity, overweight up risk of complications from radical cystectomy

Body mass index is independently associated with the development of complications from radical cystectomy, reports a study. Compared to patients with normal BMI, those who are overweight and obese have a higher risk.

In addition, “[a] BMI threshold of 34 kg/m² has been identified, which may inform prehabilitation treatment strategies,” the researchers said.

This study sought to identify such a threshold and examine the relationship between BMI subcategories and perioperative complications from radical cystectomy. The research team extracted data from the Canadian Bladder Cancer Information System, a prospective registry across 14 academic centres.

A total of 589 patients were included in the analysis. Perioperative (≤90 days) complications were compared between BMI subcategories. The researchers also performed unconditional multivariable logistic regression and cubic spline analysis to determine the association between BMI and complication risk, as well as identify a BMI threshold.

Perioperative complications occurred in 51 (30 percent) normal BMI patients, 97 (43 percent) overweight, and 85 (43 percent) obese (p=0.02). BMI independently predicted the development of any complication (odds ratio [OR], 1.04, 95 percent confidence interval [CI], 1.01‒1.07).

Of note, the predicted complication risk began to increase consistently above a BMI threshold of 34 kg/m². Patients who were overweight (OR, 2.00, 95 percent CI, 1.26‒3.17) and obese (OR, 1.98, 95 percent CI, 1.24‒3.18) showed a higher risk of complications than those with normal BMI.

“A BMI threshold may be helpful in prehabilitation to aid patient counselling and inform weight loss strategies to potentially mitigate obesity-associated complication risk,” the researchers said.