RT Journal
A1 Rege RV
T1 Is a “simple measurement” of intra-abdominal fat a simple tool for a surgeon?: Comment on “simple measurement of intra-abdominal fat for abdominal surgery outcome prediction”
JF Archives of Surgery
JO Archives of Surgery
YR 2010
FD November 15
VO 145
IS 11
SP 1073
OP 1074
DO 10.1001/archsurg.2010.207
UL http://dx.doi.org/10.1001/archsurg.2010.207
AB 
Let us examine the OR of 1.09 for mortality vs IAF, which tells us that the OR increases 9.X% per millimeter increase in IAF. A 2-mm increase in IAF thus increases the OR 1.09 for the first millimeter times 1.09 for the second millimeter, so any increase (x) in IAF OR will be 1.09x. Using data from the original study, I estimate mortality to range from 0.6% at an IAF measurement of 2 mm to 31.4% at an IAF measurement of 60 mm. These notable risk differences would certainly alter approaches to patients if my model accurately fits the data. From a practical point of view, the reader would benefit from a formula, graph, or table that models risk at any IAF value. Answers to several questions also would be helpful: Are risk and IAF linearly related or are there cutoff points where risk increases rapidly or plateaus? Are data applicable to other upper abdominal operations and at other treatment sites? Are there perioperative interventions that lower risk?