Shariq OA, et al. - The clinicians examined the effects of metabolic syndrome on postoperative 30-day morbidity, mortality, and utilization of hospital resources in a large cohort of patients undergoing elective laparoscopic adrenalectomy. The risk for postoperative complications after laparoscopic adrenalectomy was increased with the presence of metabolic syndrome. It was correlated with 2-fold risk for blood transfusion and 34% increased odds of a prolonged hospital stay.

Methods

• The clinicians identified patients who underwent laparoscopic adrenalectomy from 2005 to 2014 in the American College of Surgeons National Surgical Quality Improvement Program database.
• They defined patients with body mass index ≥30 kg/m² who also had diabetes and hypertension requiring medications as having metabolic syndrome.
• They performed univariate and multivariable analyses for the outcomes of 30-day mortality/morbidity, major complications, and utilization of hospital resources (prolonged duration of stay ≥3 days and requirement for perioperative blood transfusion).

Results

• The clinicians included 3,502 patients in the study.
• Out of them, 395 had metabolic syndrome (11.3%).
• Compared to patients without metabolic syndrome, patients with metabolic syndrome were older (P < .001) and had a greater percentage of preoperative comorbidities (P < .05).
• Metabolic syndrome was correlated with an increased risk for mortality/morbidity, major complications, duration of stay, operative time, and risk for blood transfusion (all P < .001), in unadjusted analysis.
• Metabolic syndrome was an independent predictor of overall mortality/morbidity (odds ratio, 1.86; P < .001), major complications (odds ratio, 1.99; P < .001), pulmonary complications (odds ratio, 1.83; P=.049), the need for blood transfusion (odds ratio, 1.94; P=.04), and prolonged length of stay (odds ratio odds ratio, 1.34; P=.02), in multivariable analysis.