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Risk and Predictors of Postoperative Mortality in Patients With Obesity Undergoing Trauma Laparotomy: A Systematic Review and Meta-Analysis With Meta-Regression

Aya Kambal, Libor Hurt, Michalis Iosifidis, Shahin Hajibandeh Orcid Logo, SHAHAB HAJIBANDEH

The American Surgeon™

Swansea University Author: SHAHAB HAJIBANDEH

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DOI (Published version): 10.1177/00031348261425180

Abstract

AimsTo evaluate the effect of obesity on postoperative mortality after trauma laparotomies.MethodsA PRISMA-compliant meta-analysis with meta-regression using random-effects modeling was conducted (last search: August 01, 2025). All studies comparing the risk of postoperative mortality in adult patie...

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Published in: The American Surgeon™
ISSN: 0003-1348 1555-9823
Published: SAGE Publications 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71508
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spelling 2026-03-17T16:33:21.5046484 v2 71508 2026-02-26 Risk and Predictors of Postoperative Mortality in Patients With Obesity Undergoing Trauma Laparotomy: A Systematic Review and Meta-Analysis With Meta-Regression b95fa4fe8ce5515ba689c728410200bd SHAHAB HAJIBANDEH SHAHAB HAJIBANDEH true false 2026-02-26 AimsTo evaluate the effect of obesity on postoperative mortality after trauma laparotomies.MethodsA PRISMA-compliant meta-analysis with meta-regression using random-effects modeling was conducted (last search: August 01, 2025). All studies comparing the risk of postoperative mortality in adult patients with and without obesity (BMI ≥30) undergoing trauma laparotomies were included. The certainty of evidence was evaluated using GRADE system.ResultsNine studies comprising 19,780 patients were included (obesity group: 6474; no obesity group: 13,306). The obesity and no obesity groups were comparable in terms of male sex (RD: −0.03, 95% CI −0.06, 0.00, P = .090), injury severity score (MD: 0.96, 95% CI −0.36, 2.29, P = .160), penetrating mechanism of injury (RD: −0.01, 95% CI −0.03, 0.00, P = .150), and blunt mechanism of injury (RD: 0.01, 95% CI −0.00, 0.03, P = .150). The patients in the obesity group were older (MD: 4.18 years; 95% CI 2.19, 6.18, P < .0001). The risk of postoperative mortality was higher in patients with obesity (OR: 1.33, 95% CI 1.09, 1.64. P = .006). Injury severity score (coefficient: 0.017, P = .004) and blunt mechanism (coefficient: 0.263, P = .017) were associated with an increased risk of mortality; penetrating mechanism (coefficient: −0.263, P = .017) was associated with a reduced risk of mortality; and age (coefficient: −0.004, P = .779) and male sex (coefficient: −0.055, P = .908) did not affect the mortality.ConclusionsObesity is associated with increased postoperative mortality in patients undergoing trauma laparotomies (moderate certainty). Injury severity score and blunt mechanism of injury may increase the risk of mortality in obese patients undergoing trauma laparotomies. Journal Article The American Surgeon™ 0 SAGE Publications 0003-1348 1555-9823 obesity; laparotomy; trauma; mortality 27 2 2026 2026-02-27 10.1177/00031348261425180 COLLEGE NANME COLLEGE CODE Swansea University SU Library paid the OA fee (TA Institutional Deal) 2026-03-17T16:33:21.5046484 2026-02-26T15:38:25.2488231 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science Aya Kambal 1 Libor Hurt 2 Michalis Iosifidis 3 Shahin Hajibandeh 0000-0001-6159-1068 4 SHAHAB HAJIBANDEH 5 71508__36433__669230160115481bbedc9822f39ec8d5.pdf 71508.VoR.pdf 2026-03-17T16:29:26.9078044 Output 982520 application/pdf Version of Record true © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution 4.0 License. true eng https://creativecommons.org/licenses/by/4.0/
title Risk and Predictors of Postoperative Mortality in Patients With Obesity Undergoing Trauma Laparotomy: A Systematic Review and Meta-Analysis With Meta-Regression
spellingShingle Risk and Predictors of Postoperative Mortality in Patients With Obesity Undergoing Trauma Laparotomy: A Systematic Review and Meta-Analysis With Meta-Regression
SHAHAB HAJIBANDEH
title_short Risk and Predictors of Postoperative Mortality in Patients With Obesity Undergoing Trauma Laparotomy: A Systematic Review and Meta-Analysis With Meta-Regression
title_full Risk and Predictors of Postoperative Mortality in Patients With Obesity Undergoing Trauma Laparotomy: A Systematic Review and Meta-Analysis With Meta-Regression
title_fullStr Risk and Predictors of Postoperative Mortality in Patients With Obesity Undergoing Trauma Laparotomy: A Systematic Review and Meta-Analysis With Meta-Regression
title_full_unstemmed Risk and Predictors of Postoperative Mortality in Patients With Obesity Undergoing Trauma Laparotomy: A Systematic Review and Meta-Analysis With Meta-Regression
title_sort Risk and Predictors of Postoperative Mortality in Patients With Obesity Undergoing Trauma Laparotomy: A Systematic Review and Meta-Analysis With Meta-Regression
author_id_str_mv b95fa4fe8ce5515ba689c728410200bd
author_id_fullname_str_mv b95fa4fe8ce5515ba689c728410200bd_***_SHAHAB HAJIBANDEH
author SHAHAB HAJIBANDEH
author2 Aya Kambal
Libor Hurt
Michalis Iosifidis
Shahin Hajibandeh
SHAHAB HAJIBANDEH
format Journal article
container_title The American Surgeon™
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publishDate 2026
institution Swansea University
issn 0003-1348
1555-9823
doi_str_mv 10.1177/00031348261425180
publisher SAGE Publications
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
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description AimsTo evaluate the effect of obesity on postoperative mortality after trauma laparotomies.MethodsA PRISMA-compliant meta-analysis with meta-regression using random-effects modeling was conducted (last search: August 01, 2025). All studies comparing the risk of postoperative mortality in adult patients with and without obesity (BMI ≥30) undergoing trauma laparotomies were included. The certainty of evidence was evaluated using GRADE system.ResultsNine studies comprising 19,780 patients were included (obesity group: 6474; no obesity group: 13,306). The obesity and no obesity groups were comparable in terms of male sex (RD: −0.03, 95% CI −0.06, 0.00, P = .090), injury severity score (MD: 0.96, 95% CI −0.36, 2.29, P = .160), penetrating mechanism of injury (RD: −0.01, 95% CI −0.03, 0.00, P = .150), and blunt mechanism of injury (RD: 0.01, 95% CI −0.00, 0.03, P = .150). The patients in the obesity group were older (MD: 4.18 years; 95% CI 2.19, 6.18, P < .0001). The risk of postoperative mortality was higher in patients with obesity (OR: 1.33, 95% CI 1.09, 1.64. P = .006). Injury severity score (coefficient: 0.017, P = .004) and blunt mechanism (coefficient: 0.263, P = .017) were associated with an increased risk of mortality; penetrating mechanism (coefficient: −0.263, P = .017) was associated with a reduced risk of mortality; and age (coefficient: −0.004, P = .779) and male sex (coefficient: −0.055, P = .908) did not affect the mortality.ConclusionsObesity is associated with increased postoperative mortality in patients undergoing trauma laparotomies (moderate certainty). Injury severity score and blunt mechanism of injury may increase the risk of mortality in obese patients undergoing trauma laparotomies.
published_date 2026-02-27T05:34:26Z
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