When body mass index fails to measure up: perinephric and periumbilical fat as predictors of operative risk

Luke Martin, Gillian Seton, Booth Aldred, Paul Hopkins, Jessica Chan, Marta E. Heilbrun, Mary Mone, Courtney Scaife, William Peche

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background Obesity has been associated with worse outcomes and increased surgical technical difficulty. Perinephric fat (PNF) and periumbilical fat (PUF) are alternative metrics to body mass index. We hypothesized that PUF and PNF would offer improved prediction of perioperative risk. Methods 249 patients were retrospectively reviewed after elective, pelvic colorectal resections. PNF and PUF were collected using axial imaging. Operative risk measurements included estimated blood loss (EBL) and operative time (OT). Results In multivariate analyses of women, PUF and PNF were significant predictors of EBL; PNF was a significant predictor of OT. A 4.7-mm increase in PNF predicted a 15-minute increase in OT and 55-cc increase in EBL. An 8.6-mm increase in PUF predicted a 55-cc increase in EBL. In men, no metric was predictive. Conclusions In women, PNF and PUF may offer improved metrics for risk stratification, which can have important clinical and financial implications.

Original languageEnglish (US)
Pages (from-to)1039-1046
Number of pages8
JournalAmerican journal of surgery
Issue number6
StatePublished - Dec 1 2016
Externally publishedYes

Bibliographical note

Funding Information:
This investigation was supported by the University of Utah Study Design and Biostatistics Center , with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences , National Institutes of Health , through grant 8UL1TR000105 (formerly UL1RR025764).

Publisher Copyright:
© 2016


  • Body mass index
  • Colorectal surgery
  • Obesity
  • Perinephric fat
  • Perioperative risk assessment
  • Periumbilical fat


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