Abstract
Preoperative body mass index (BMI) is frequently considered during assessment for hernia surgery, but a single threshold can obscure differences in operative approach, patient selection and outcome ascertainment. We reanalyzed an openly released retrospective cohort of adults with diabetes treated in Riyadh, Saudi Arabia, to estimate the association between continuous BMI and recorded postoperative recurrence. A frozen analysis plan specified Firth logistic regression adjusted for age, sex and surgical approach, with profile-likelihood intervals and bootstrap uncertainty for standardized risks. Of 147 released records, 141 had recurrence status; the primary model included 135 patients and 21 recurrences. The adjusted odds ratio per five-unit higher BMI was 0.87 (95% confidence interval 0.55–1.33). Standardized recurrence probabilities at BMI 25 and 35 were 18.5% and 14.9%, respectively; the difference was -3.6 percentage points (95% interval -16.2 to 5.3). The estimate moved across the null after additional glycemic-category adjustment. Missing follow-up dates, absent hernia subtype and differences between the public file and published denominators constrained interpretation. These data do not establish either a protective BMI association or a safe surgical threshold. They support cautious interpretation of small local cohorts and better prospective documentation of perioperative risk and recurrence ascertainment.
Keywords
- body mass index
- hernia recurrence
- perioperative assessment
- diabetes
- Saudi Arabia
- retrospective cohort
- reproducibility
Declarations
- Ethics approval
- NA
- Consent to participate
- NA
- Consent for publication
- NA
- Funding
- NA
- Competing interests
- NA
- Author contributions
- NA
- Data availability
- NA
- Registration
- NA
- Acknowledgements
- NA
Comments
Commenting requires an account and sign-in.