BMI*VFA/SFA: a new fat parameter associated with outcome following major liver resection.

Mensink, S. (Sabine) (2014) BMI*VFA/SFA: a new fat parameter associated with outcome following major liver resection. thesis, Medicine.

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Abstract

Objective: To assess whether BMI multiplied by visceral fat area/subcutaneous fat area has the greatest effects on complications after major liver resections as body mass index alone is not a good measure for the body’s fat distribution and the risks that it implies. Secondly, we studied whether BMI*VFA/SFA was related to mortality and survival. Our aim is to create a preoperative risk model for patients undergoing major liver resection. Methods: We carried out a retrospective study of 73 patients who underwent major liver resection. Preoperative CT scans were used to quantify the visceral and subcutaneous fat areas at the level of the umbilicus, the truncus coeliacus, and the iliac crest. A fourth measurement included a volume measurement of 20 mm cranially from the iliac crest. Patients were categorized in two groups of complications; group I contained patients with no or minor complications, group II consisted of patients with severe complications (Clavien-Dindo ≥ 3). All characteristics and outcomes were prospectively studied. Results: 90-day complication rate was 69.9% of which 34.2% being severe. Neither BMI*VFA/SFA nor BMI showed any relation with postoperative complications. 90-day mortality was 0%. Overall survival was significantly lower among high BMI*VFA/SFA patients compared to low BMI*VFA/SFA patients, measured at the level of the truncus coeliacus (HR: 3.2, 95% CI 1.1 – 9.6, P = 0.035). All other levels and BMI didn’t show a connection with survival. Conclusions: BMI*VFA/SFA as new fat parameter lacked to show any correlation with postoperative complications after major liver resection. However, a high BMI*VFA/SFA measured at the level of the truncus coeliacus, has a significant negative impact on survival.

Item Type:	Thesis (Thesis)
Supervisor name:	Klaase, Dr. J.M. and Medisch Spectrum Twente and Enschede
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:58
Last Modified:	25 Jun 2020 10:58
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1849

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