Impact of visceral fat distribution on postoperative complications in high-aged patients undergoing gastric cancer surgery: A cross-sectional study

Table 1 The controlling nutritional status

Parameter	Malnutritional status
	Normal	Mild	Moderate	Severe
ALB (g/dL)	3.5-4.5	3.0-3.49	2.5-2.9	< 2.5
Score	0	2	4	6
Total lymphocytes (/mm3)	≥ 1600	1200-1599	800-1199	< 800
Score	0	1	2	3
Cholesterol (mg/dL)	≥ 180	140-180	100-139	< 100
Score	0	1	2	3
Total	0-1	2-4	5-8	9-12

ALB: Albumin.

Table 2 Comparison of the baseline characteristics of patients, n (%)

Item	Without complication	With complication	t/χ2	P value
Age	68.23 ± 7.94	69.12 ± 7.45	-0.892	0.419
Sex
Male	92 (65.2)	15 (68.2)	0.073	0.788
Female	49 (34.8)	7 (31.8)
BMI (kg/m2)	25.87 ± 5.19	29.14 ± 3.28	8.091	0.000
Combined hypertension
Yes	34 (24.1)	5 (22.7)	0.020	0.887
No	107 (75.9)	17 (77.3)
Combined diabetes
Yes	21 (14.9)	9 (42.9)	9.472	0.002
No	120 (85.1)	12 (57.1)
Combined hyperlipidemia
Yes	16 (11.3)	6 (27.3)	4.134	0.042
No	125 (88.7)	16 (72.7)
ASA score
I	61 (43.3)	3 (13.6)	7.004	0.008
II	80 (56.7)	19 (86.4)
Primary tumor site
Esophagogastric junction	55 (39.0)	9 (40.9)	0.123	0.940
Proximal stomach	49 (34.8)	8 (36.4)
Distal stomach	37 (26.2)	5 (22.7)
TNM stage
I stage	38 (27.0)	5 (22.7)	0.175	0.676
II stage	103 (73.0)	17 (77.3)
VFA	105.28 ± 37.61	151.98 ± 45.33	5.872	0.000
SFA	213.60 ± 57.18	247.35 ± 79.35	2.523	0.013
TFA	318.88 ± 47.40	399.33 ± 62.34	9.108	0.000
VSR	0.79 ± 0.41	1.07 ± 0.56	6.129	0.000

BMI: Body mass index; ASA: American Society of Anesthesiologists; VFA: Visceral fat area; SFA: Subcutaneous fat area; TFA: Total fat area; VSR: Visceral to subcutaneous fat area ratio; TNM: Tumor-node-metastasis.

Table 3 Relationship between postoperative complications and visceral fat area, n (%)

Item	Anastomotic lesions	Surgical incision infection or fat liquefaction	Lung infection	Abdominal infection	Intestinal obstruction	Other	With complication
VFA-L	1 (0.9)	2 (1.8)	1 (0.9)	1 (0.9)	1 (0.9)	2 (1.8)	7 (6.4)
VFA-H	4 (7.4)	5 (9.3)	2 (3.7)	2 (3.7)	1 (1.9)	3 (5.6)	15 (27.8)
χ2	5.115	4.843	1.552	1.552	0.260	1.681	14.106
P value	0.024	0.028	0.213	0.213	0.610	0.195	0.000

VFA-L: Low visceral fat area; VFA-H: High visceral fat area.

Table 4 Analysis of postoperative related conditions and visceral fat area

Item	Operation time (minute)	Intraoperative blood loss (mL)	First exhaust time (day)	Postoperative hospital stay (day)
VFA-L	224.31 ± 51.89	127.93 ± 98.26	2.89 ± 1.13	10.13 ± 4.75
VFA-H	268.55 ± 63.41	163.77 ± 105.27	3.02 ± 1.88	11.28 ± 7.32
t	6.064	8.719	2.981	5.174
P value	0.000	0.000	0.109	0.552

VFA-L: Low visceral fat area; VFA-H: High visceral fat area.

Table 5 Analysis of serological indicators and visceral fat area

Item	ALB (g/L)	Hb (g/L)	CRP (mg/L)	TC (mmol/ L)	TG (mmol/L)	WBC (109/L)
VFA-L	33.12 ± 4.67	118.29 ± 39.61	6.14 ± 2.47	4.71 ± 1.24	1.99 ± 1.01	13.89 ± 3.44
VFA-H	28.53 ± 3.92	115.99 ± 41.23	13.58 ± 4.36	6.33 ± 2.35	2.78 ± 1.76	16.73 ± 5.27
t	-3.378	-0.276	4.416	2.434	2.136	3.192
P value	0.452	0.735	0.0007	0.031	0.045	0.057

VFA-L: Low visceral fat area; VFA-H: High visceral fat area; ALB: Albumin; Hb: Hemoglobin; CRP: C-reactive protein; TG: Triglycerides; TC: Total cholesterol; WBC: White blood cell.

Table 6 Risk factors of complication analyzed by binary logistic regression models

Item	B	SE	Wald	P value	OR	95%CI
						Upper	Lower
BMI (kg/m2)	0.827	0.366	5.624	0.019	1.952	3.624	1.183
Combined diabetes	0.688	0.313	3.705	0.035	1.672	3.185	1.079
Combined hyperlipidemia	0.455	0.241	1.545	0.217	1.544	3.103	0.844
ASA score	0.040	0.019	4.635	0.031	1.041	1.080	1.004
VFA	0.951	0.342	8.531	0.004	2.597	4.853	1.479
SFA	-0.341	0.169	2.121	0.142	0.773	1.074	0.529
TFA	0.857	0.306	6.133	0.013	1.655	4.040	1.076
VSR	0.868	0.325	7.879	0.008	2.046	5.640	1.196

ASA: American Society of Anesthesiologists; VFA: Visceral fat area; SFA: Subcutaneous fat area; TFA: Total fat area; VSR: Visceral subcutaneous fat area ratio; OR: Odds ratio; BMI: Body mass index.