Waist-to-hip ratio is a better predictor than body mass index for morbidity in abdominally based breast reconstruction

Document Type

Article

Abstract

BACKGROUND: Body mass index is a universally recognized measure of obesity. However, it does not take body fat distribution (BFD) into account, which has been established as a significant risk factor in both medicine and surgery. The objective of this study was to compare previously developed anthropometric measures of BFD with body mass index in predicting morbidity with abdominally based microsurgical breast reconstruction. METHODS: A review of patients who underwent abdominally based breast reconstruction was performed. Multivariate logistic regression was performed to determine the relationship between complications (recipient, donor, total) with body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, conicity index, and abdominal volume index. RESULTS: A total of 325 patients who underwent 442 flaps were analyzed. Waist circumference (OR, 1.16; 95% CI 1.07-1.76), waist-to-hip ratio (OR, 1.94; 95% CI 1.25-3.35), and waist-to-height ratio (OR, 1.19; 95% CI 1.01-1.70) were significant risk factors for recipient site complications. Body mass index (OR, 1.14; 95% CI 1.01-1.56), and waist-to-hip ratio (OR, 2.01; 95% CI 1.30-3.95) were significant risk factors for donor site complications. Waist-to-hip ratio (OR, 1.87; 95% CI 1.22-4.00) was the only measure found to be a significant risk factor for experiencing any complication. A waist-to-hip ratio >0.84 was associated with increased risk. CONCLUSIONS: Waist-to-hip ratio is a significant risk factor for recipient and donor site morbidity in abdominally based breast reconstruction. It is a readily calculable and clinically significant measure distinct from body mass index that should be considered for use in clinical care and research.

Medical Subject Headings

Abdominal Fat (transplantation); Adult; Body Mass Index; Breast Neoplasms (pathology, surgery); Cohort Studies; Confidence Intervals; Female; Graft Rejection (epidemiology); Humans; Incidence; Mammaplasty (adverse effects, methods); Mastectomy (methods); Middle Aged; Multivariate Analysis; Postoperative Complications (epidemiology, physiopathology); Predictive Value of Tests; Prognosis; Retrospective Studies; Risk Assessment; Waist-Hip Ratio

Publication Date

10-1-2018

Publication Title

Microsurgery

E-ISSN

1098-2752

Volume

38

Issue

7

First Page

731

Last Page

737

PubMed ID

29964332

Digital Object Identifier (DOI)

10.1002/micr.30346

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