The Impact of Metabolic Syndrome on Post-Operative Outcomes in Abdominal Body Contouring: A Propensity Score-Matched Nationwide Analysis
Maria J. Escobar-Domingo, MD1; Helen Xun, MD1; Angelica Hernandez Alvarez, MD1; Jose Foppiani, MD1; Iulianna C. Taritsa, BA1; Kirsten Schuster, MD1; James E. Fanning, BS1; Daniela Lee, BS1; Samuel J. Lin, MD, MBA1; Bernard T. Lee, MD, MBA, MPH1
Background:
•Metabolic syndrome (MetS) is defined by a constellation of cardiometabolic abnormalities, including hypertension, obesity, insulin resistance, and dyslipidemia.1
•The increasing prevalence has substantial implications for postoperative outcomes, with mounting evidence revealing elevated risks of postoperative myocardial infarction, pulmonary complications, renal dysfunctions, and prolonged hospital stays in patients with MetS.2-4
Objective:
•To evaluate the impact of Metabolic Syndrome on the postoperative outcomes of abdominal body contouring by concurrent abdominoplasty and panniculectomy.
Methods:
•Retrospective study on patients who underwent concurrent abdominoplasty and panniculectomy from 2012 to 2022 using the ACS-NSQIP database.
•Patients were categorized by MetS: Medically treated for diabetes mellitus, Medically treated for hypertension, Body mass index ≥ 30 kg/m2.
•Propensity score-matching was used to generate balance cohorts. Logistic and linear regression models evaluated outcomes.
Results:
•Length of stay:
•Non-MetS: 1.6 (SD 3.6)
•No Tumescent: 2.3 (SD 2.7); p=0.007
•Univariate analyses revealed significant shorter length of stay in the non-MetS group. No significant differences in other postoperative complications were found between groups.
•Logistic regression models comparing complication rates between MetS and non-MetS categories demonstrated no significant differences in wound complications, mild and severe systemic complications, and readmission rates.
Patients diagnosed with MetS had an average length of stay of 0.6 days longer than non-MetS patients (95% CI, [0.17,1.01]; p=0.007). No significant difference in operation time was observed between cohorts.
Conclusions:
•The presence of MetS does not appear to increase postoperative wound and systemic complications after abdominal body contouring procedures.
•Abdominal body contouring may be a safe option for patients with MetS. Nonetheless, the longer hospital length stays observed in patients with MetS may potentially translate to increased overall costs.
•Future directions: Continued research is warranted to comprehensively assess the economic implications of MetS in the context of abdominal body contouring and the long-term impact of these cardiometabolic derangements.
