Scleroderma Complications Worse in Blacks Than Whites: Study

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Men More Prone to Complications After Brain, Spine Surgery

HealthDay – 13 mins ago FRIDAY, April 20 (HealthDay News) -- Men are twice as likely as women to have complications after brain or spinal surgery, and also spend more time in the hospital after the operation, a new study finds.

The findings suggest that a patient's gender, along with other factors, should be taken into account to provide the best possible estimates of risk for patients scheduled for neurosurgery, the University of Michigan Medical School researchers said.

The researchers analyzed data on more than 900 people who had brain or spinal surgery between 2006 and 2009. The overall complication rates within 30 days after surgery were 18.6 percent for brain surgery patients and 10.8 percent for spinal surgery patients.

The complication rate for men was 20.3 percent, compared to 11.3 percent for women. The rate for men remained twice that of women even after the researchers adjusted for other factors such as age, tobacco and alcohol use, and health problems such as high blood pressure, coronary artery disease and diabetes.

Complications also were more common in older patients and in those with coronary artery disease.

Men spent an average of 7.5 days in the hospital, compared with 5.7 days for women. But gender did not affect the average length of stay in the intensive care unit after surgery.

Multiple factors likely contribute to the different complication rates in men and women, including "psychosocial, hormonal or underlying disease differences," the researchers said.

For example, the lower complication rate in women could be due to better social support, "neuroprotective" effects of estrogen or lower rates of cardiovascular disease.

The study appears in the April issue of the journal Neurosurgery.

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Body mass index not linked to post-surgical complications, survival in esophageal adenocarcinoma, study suggests

ScienceDaily (Mar. 28, 2012) — Researchers at Moffitt Cancer Center in Tampa, Fla., have found -- contrary to previous studies linking inferior outcomes in patients with gastrointestinal malignancies to higher body mass index (BMI) -- that in their study of BMI and negative outcomes, there was no such link. They concluded that BMI was not associated with either surgical complications or esophageal cancer patient survival.

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Their study was published in the current online issue of the Journal of Gastrointestinal Surgery, published by the Society for Surgery of the Alimentary Tract.

"The incidence of esophageal cancer in North America is rising," said study co-author Kenneth L. Meredith, M.D., assistant member at Moffitt and chief of the Esophagogastric Oncology Section. "Corresponding to that rise, there has been a dramatic rise in overweight and obese people as defined by the World Health Organization's guidelines indicating those having a BMI of 25 to 29.9 as being overweight and those who are obese as having a BMI of over 30."

According to the researchers, the increase in obesity and the increase in esophageal cancer has been linked, as has obesity been similarly linked with other kinds of cancers. Obesity is recognized as a risk factor for esophageal cancer. What remains in question, however, is whether a high BMI affects post-surgical complications and overall survival among esophageal cancer patients who have been treated with chemotherapy, radiation and surgery.

"The correlation of obesity with surgical risks and postoperative survival is more important given the rise in obesity rates, yet more clarity on potential correlation is needed," said Meredith. "The literature shows mixed study results."

In their paper, the authors cited a number of studies that correlated lower BMI with better outcomes for a variety of cancers as well as studies that found no prognostic significance correlating higher BMI with poorer outcomes.

Because of the prevailing belief that patients with a high BMI tend to have more surgical complications as compared to normal weight patients, the Moffitt researchers examined esophageal cancer patient data on BMI for links to surgical risk and postoperative survival, especially for those patients with high BMI.

Their study included 303 esophageal cancer patients treated with chemotherapy, radiation and surgery who were stratified by their BMI to include those with BMIs less than 25 to greater than 35. The only demographic differences were in gender, with a higher proportion of males in the BMI 25 to 30 group.

"Our study demonstrated no significant differences in overall survival or disease-free survival in relation to BMI for patients with esophageal adenocarcinoma who underwent surgery after prior treatment with chemotherapy and radiation," said Meredith. "Additionally, there were no differences in perioperative complications or mortality associated with BMI. In short, our data failed to demonstrate a link between BMI and surgical outcome."

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