Data on the association of BMI and SSI in patients with IBD is limited by single-institution design and the combination of patients with Crohn’s disease (CD) and Ulcerative Colitis. We aim to describe the association of BMI with SSI in patients with CD. We hypothesize that higher BMI is associated with higher risk for SSI.
Using the 2012-2014 ACS-NSQIP Procedure Targeted Database, patients with CD who underwent colectomy between 2012-2014 were identified. Patients were stratified by weight status to underweight, normal weight, overweight and BMI class I (30-34.9), II (35-39.9) and III (>40). Patient demographics, preoperative comorbidities and surgical characteristics were compared. Primary outcomes were wound complications (SSI, organ space SSI, anastomotic leak) and secondary outcomes included other reported NSQIP-complications.
Of patients (N=3734) with CD, 12.29% were classified as underweight, 43.92% as normal weight, 24.24%, 12.35%, 4.79% and 2.41% for overweight, BMI class I, II and III respectively. Higher BMI was associated with a greater percentage of SSI: 6.4%, 8.89%, 12.85%, 16.67% in the normal weight, BMI class I, II, and III respectively (p-value<0.001). There was an inverse relationship with weight organ space SSI. Organ space SSI rates were 12.2%, 7.13%, 6.85% and 7.38% in underweight, normal weight, overweight, and BMI classes I, II and III, respectively (p-value<0.001). There was no significant difference in anastomotic leak rate.
Patients with CD and high BMI are at increased risk for SSI but not organ space SSI or anastomotic leak. Interestingly, underweight CD patients are at increased risk for organ space SSI.
