Open AccessMulticentre prospective cohort study of body mass index and postoperative complications following gastrointestinal surgery
Author(s) -
T M Drake,
Dmitri Nepogodiev,
Stephen J. Chapman,
James C Glasbey,
Chetan Khatri,
Chia Yew Kong,
Henry Claireaux,
M F Bath,
Midhun Mohan,
Lisa McNamee,
Michael E. Kelly,
Harriet Mitchell,
J Edward Fitzgerald,
Ewen M Harrison,
Aneel Bhangu,
Henry Claireaux,
Irini M. Antoniou,
Richard H. Dean,
Natalie A. Davies,
Shaun Trecarten,
Ian Henderson,
Charlotte Holmes,
Joanne Wylie,
R H Shuttleworth,
Anurag Jindal,
F Hughes,
Pishoy Gouda,
Lisa McNamee,
Robert Fleck,
Michael Hanrahan,
Priyadarssini Karunakaran,
J H Chen,
Mark Sykes,
Rajiv Sethi,
S. Suresh,
Panna Patel,
M Patel,
Rick Varma,
Jameel Mushtaq,
Buket Gundogan,
William Bolton,
Midhun Mohan,
T Khan,
Joshua Burke,
R Morley,
Nicolò Favero,
R. Adams,
Vanushia Thirumal,
Ewan D. Kennedy,
Kenneth Ong,
Yi Tan,
Joseph Gabriel,
Ali Bakhsh,
Jillian Low,
Ahmet Levent Yener,
Vlad Paraoan,
Ryan Preece,
Thomas Tilston,
Elspeth Cumber,
S Dean,
Talisa Ross,
Eleanor McCance,
H. Amin,
L. Satterthwaite,
Keiran Clement,
Robert Gratton,
Edward David Mills,
Seehui Chiu,
Guo Dung Hung,
N M Rafiq,
John D. Hayes,
K Robertson,
K Dynes,
Han-Sheng Huang,
Shershah Assadullah,
Joseph W. Duncumb,
Richard Moon,
Stephanie Poo,
J.K. Mehta,
K Joshi,
Rory Callan,
Jonathan Norris,
Nicholas Chilvers,
Harry Keevil,
P Jull,
Shweta Mallick,
D. Elf,
L. M. Carr,
C. Player,
Eric Barton,
Aurélie Martin,
S.G. Ratu,
Elizabeth Roberts,
Philippe Phan,
A Dyal,
Joanne Rogers,
Andrew Henson,
Neil Reid,
Dermot Burke,
G. Culleton,
Sarah D. Lynne,
Dermot Burke,
Sufyan Mansoor,
Caitlin W. Brennan,
R. Blessed,
Caroline L. Holloway,
Arnold D. Hill,
Thomas Goldsmith,
Sharon Mackin,
S Kim,
Evelina Woin,
Gregory A. Brent,
Juli Coffin,
Oliver J. Ziff,
ZD Momoh,
R. K. Debenham,
Malik Irfan Ahmed,
Cissy Yong,
Jonathan Wan,
Hannah Charlotte Copley,
Pritish Raut,
Faraz Chaudhry,
R H Shuttleworth,
G Nixon,
Courtney Dorman,
Ryan Choon Kiat Tan,
S. Kanabar,
N. Canning,
M. Dolaghan,
Nicole S. Bell,
Mary McMenamin,
Ashok Chhabra,
Kathryn Duke,
Lindsay C. Turner,
Tejal Patel,
L S Chew,
Mehdi Ali Mirza,
Surabhika Lunawat,
Babatunde Oremulé,
Nicholas T. Ward,
M Khan,
E. Tian Tan,
David Roderick Maclennan,
Richard McGregor,
Elizabeth Chisholm,
E J Griffin,
Louise Bell,
Belinda Hughes,
J. Davies,
H Haq,
Hussien Ahmed,
N. Ungcharoen,
C. Whacha,
R. Thethi,
Rachel Markham,
A H Y Lee,
E Batt,
Nicholas Bullock,
C.T. Francescon,
J. Davies,
Nusrat Shafiq,
Jiashi Zhao,
Sayinthen Vivekanantham,
Ishani Barai,
Jessica L. Allen,
Dominic C. Marshall,
Charlotte McIntyre,
Holly Wilson,
Anita Ashton,
Chong Lek,
Nebil Behar,
M. Davis-Hall,
N. Seneviratne,
S Kim,
Loïc Estève,
Mert Sirakaya,
S Ali,
Scott D. Pope,
Jaimo Ahn,
Anna Craig-Mcquaide,
W.A. Gatfield,
Sharon E Leong,
A.M. Demetri,
Anne Kerr,
Clare M. Rees,
Jane Loveday,
S Liu,
Maheshi P C Wijesekera,
Dipen M. Maru,
Mark Attalla,
Nicholas A. Smith,
David Esteban Brown,
P. Sritharan,
Apar Shah,
V. Charavanamuttu,
G. Heppenstall-Harris,
Kelvin K. Ng,
T. Raghvani,
Nick Rajan,
K. Hulley,
Nick Moody,
Marli Williams,
Arthur Cotton,
Milad Sharifpour,
Kaung Lwin,
Melissa Bright,
Abhishek Chitnis,
Mohammed Abdel-Hadi,
Akuilina Semana,
Franklin G. Morgan,
Rebecca Reid,
Jane Dickson,
Lorinda Anderson,
Ronan McMullan,
Jane Dickson,
N Ahern,
A Ahmad Asmadi,
Lorinda Anderson,
Jiabin Xuan,
Lauren Crozier,
Stephen McAleer,
David Lees,
AT Adebayo,
Mautushi Das,
Alexander Amphlett,
A. Al-Robeye,
Alice Valli,
Jessi Khangura,
A. Winarski,
Ahmed Ali,
Jessi Khangura,
Helen Woodward,
C Gouldthrope,
Megan C. Turner,
K Sasapu,
Michael Tonkins,
Jonathan Wild,
Michael J. Robinson,
J. Hardie,
R. Heminway,
Ruth Narramore,
N. Ramjeeawon,
A. D. Hibberd,
Forrest Winslow,
W Ho,
Bradford Chong,
Khong Hee Lim,
Samuel B. Ho,
J.A. Crewdson,
S. Singagireson,
Neeraj Kalra,
Foteini Stefania Koumpa,
H. I. Jhala,
Wai Cheong Soon,
Monil Karia,
Michael Greshan Rasiah,
Diamantis Xylas,
H Gilbert,
M. Sundar-Singh,
Jonathan Wills,
Jameel Mushtaq,
Sobia Akhtar,
S. Patel,
Hu Liu,
Charlotte BrathwaiteShirley,
H Nayee,
Oreekha Amin,
Tarun Rangan,
E Turner,
Catherine H McCrann,
Rowan Forbes Shepherd,
N Patel,
J. Prest-Smith,
Eric Y Auyoung,
A. Murtaza,
Amy Coates,
O. Prys-Jones,
Martin King,
Stuart Gaffney,
Charlotte Dewdney,
I. Nehikhare,
Jessica A. Lavery,
John Bassett,
Kirsty Davies,
Kasim Ahmad,
A Collins,
Meghan Acres,
Christine Egerton,
T Khan,
Ka Ho Cheng,
X Chen,
Nicholas Chan,
Anna Sheldon,
S. Khan,
J. Empey,
Emily Ingram,
Ali Raza Malik,
Marianne Johnstone,
R. Goodier,
Jaynam Shah,
Julian Giles,
Julie Sanders,
Stewart McLure,
Sridhar E. Pal,
A. Rangedara,
A Baker,
C.A. Asbjoernsen,
C. Girling,
Lewis D Gray,
L. Gauntlett,
C Joyner,
Sajid Qureshi,
S Dean,
Y.P. Mogan,
James Ng,
Aruna Kumar,
J H Park,
David Chi Hau Tan,
K Choo,
Kausalya Raman,
P. Buakuma,
Chunhong Xiao,
S. Govinden,
Olof Thompson,
M.A. Charalambos,
Elliot John Brown,
Rickesh Bharat Karsan,
Tara Dogra,
Laetitia Bullman,
Pamela Dawson,
Arthur L. Frank,
Héla Ben Abid,
Li-Chen Tung,
Umer Qureshi,
A. Tahmina,
Bruce Matthews,
R. Harris,
A. O'Connor,
K. Mazan,
Sundas Iqbal,
Sophie Stanger,
J. Thompson,
Jacqueline A. Sullivan,
E. Uppal,
Ann Macaskill,
F.A. Bamgbose,
Christieophytou,
Ashley Carroll,
C.W. Rookes,
Uttaran Datta,
Amrita Dhutia,
S Rashid,
Nagm Eldin Abu Elnga Ahmed,
Terence Lo,
Shivam Bhanderi,
Christopher Blore,
S Ahmed,
H. J. Shaheen,
S Abburu,
S. Majid,
Zainab Abbas,
Sutopa Talukdar,
S Ahmed,
Laura Burney,
Jamie Patel,
O Al-Obaedi,
Allison Roberts,
O Al-Obaedi,
Sophia Mahboob,
Bhagwan D. Singh,
Sangini S. Sheth,
Priyesh Karia,
A Prabhudesai,
Kelvin Kow,
Kantida Koysombat,
S Wang,
Paul J. Morrison,
Y. Maheswaran,
Philip Keane,
Phillip Correia Copley,
Oliver Brewster,
Guanjie Xu,
Phillip Harries,
Carmel Wall,
Alia Al-Mousawi,
S. Bonsu,
Pedro Cunha,
Thomas Ward,
Jerry Paul,
K. Nadanakumaran,
Salim Tayeh,
Thomas Ward,
H. Holyoak,
Jéssica Remédios,
K Theodoropoulou,
Thomas Ward,
A. Luhishi,
Louis Jacob,
Fang Long,
Andrew Atayi,
Safdar Sarwar,
Olive Parker,
Jessica Harvey,
Heather Ross,
Ritika Rampal,
George Thomas,
Piyush Vanmali,
Catherine C. McGowan,
John C. Stein,
Vaila Robertson,
L Carthew,
Vannesa Yue May Teng,
J Fong,
Anne Street,
Clare Thakker,
Derek O’Reilly,
Mauro Bravo,
Aline Cecília Pizzolato,
Haseeb Anwar Khokhar,
M. J. Ryan,
Lindsay Cheskes,
Richard D. Carr,
Abdelmonim Salih,
S Bassiony,
R. C. F. Yuen,
David Chrastek,
Hugh O׳Sullivan,
Adaugo Amajuoyi,
A Wang,
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C. Y. D. Major,
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Catrin Morgan,
Maurizio Petrarca,
R Allot,
Kamlesh Verma,
Shoma Dutt,
R Allot,
Chrissie Chilima,
S Peroos,
R Allot,
Sumitro Kosasih,
Hyung-Min Chin,
L. Ashken,
Rupert Pearse,
Robert O'Loughlin,
Arathi Me,
Kavindra Singh,
Joel Norton,
Rebecca Sagar,
N. Jathanna,
Lincoln Rothwell,
Nicholas Watson,
Floyd E. Harding,
Pierre Dubé,
Hassan Khalid,
N Punjabi,
Markus Sagmeister,
Paul Gill,
SM Hossain Shahid,
Sarah Hudson-Phillips,
D. George,
J. Scott Ashwood,
Thomas Lewis,
Mahesh Shanker Dhar,
P. Sangal,
I A Rhema,
Dipak Kotecha,
Richard H. Dean,
Zeeshan Afzal,
J.A. Syeed,
Esha Prakash,
Priya Jalota,
Richard H. Dean,
Jonathan Blair Thomas Herron,
Lawrence M Kimani,
A. Delport,
Ayushi Shukla,
Vani Agarwal,
S R Raja Parthiban,
Hena Thakur,
W Cymes,
S Rinkoff,
Jennifer Turnbull,
Muhammad Hayat,
Sarah Darr,
UA Khan,
Jieqi Lim,
Andrew Higgins,
Gokul R Lakshmipathy,
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E. Canning,
A. Jaitley,
Jeffrey P. Lamont,
Ethan Toner,
Ali Ghaffar,
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Dominique Salmon,
Pishoy Gouda,
Orla O’Carroll,
Aberdeen Khan,
Michael E. Kelly,
Katherine Clesham,
Cynthia S. Palmer,
Rachel Lyons,
Michael E. Kelly,
Andrew M. Bell,
Robin Chin,
Ronan Waldron,
Michael E. Kelly,
Alan S. Trimble,
Shanice Cox,
Umair Ashfaq,
Jill Campbell,
Rachel Holliday,
George P. McCabe,
F Morris,
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S Dean,
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Rachel Vaughan,
Diana Lim,
Zoe Bakewell,
Rebecca Hughes,
R. Koshy,
Hunter Jackson,
P Narayan,
Amy Cardwell,
C.L. Jubainville,
Tahera Arif,
Lucy Elliott,
Vidushi Gupta,
Tahera Arif,
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Adenike Odeleye,
Fiza Ahmed,
Raahil Shah,
Adenike Odeleye,
Joe Pickard,
Yasir Suleman,
Adenike Odeleye,
Alexander S North,
Liusaidh McClymont,
N Hussain,
I Ibrahim,
Guat Shi Ng,
V. Wai-Sun Wong,
Alison Lim,
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Devender Mittapalli,
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Midhat Lakhani,
Natalie A. Davies,
H.Z. Bazeer,
Vishal Narwani,
Kulmeet Sandhu,
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A.M. Bucko,
James Meek,
Naomi Boxall,
Emily Heywood,
Joanne Wiltshire,
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Badrun Shurovi,
T M Drake,
Dillon Horth,
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Charn Gill,
Ingo Fisher,
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Ian Clark,
G. Aidoo-Micah,
Philip W. Stather,
Gazbar Salam,
Thomas E. Glover,
Gavin Deas,
N K Sim,
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William Wynell-Mayow,
M S Sait,
N. Mitha,
G Bernier,
Muhammad Bilal Siddiqui,
Raghav Shaunak,
Anuj Wali,
Gavin Cuthbert,
Roshni Bhudia,
Elizabeth M. Webb,
Sanjay Shah,
Nabila Ansari,
M. Thamara P. R. Perera,
Neil E. Kelly,
Ross McAllister,
Guy Stanley,
Colm Keane,
Veeranna Shatkar,
C. MaxwellArmstrong,
LM Henderson,
Natalie Maple,
R Manson,
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Elliot John Brown,
Elisabeth Semple,
Marcos Mills,
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A. Marsh,
A Ramnarine,
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Paul Jewell,
Elizabeth Whatling,
Nadia Hitchen,
M Chen,
Brian K. P. Goh,
J Fern,
Sophie Rogers,
Laura Derbyshire,
David Robertson,
N Abuhussein,
Praveena Deekonda,
Amer Abid,
Ali Bakhsh,
Peter Harrison,
L. Aildasani,
Hannah Turley,
Mohamed Sherif,
Gargi Pandey,
Joseph Filby,
Andrew James Johnston,
Éilish Burke,
Mohamed Farah Yusuf Mohamud,
Kajal Gohil,
A Tsui,
Rajdeep Singh,
Shujing Jane Lim,
Karen O’Sullivan,
L.L. McKelvey,
Stephen O’Neill,
Helen Roberts,
F S Brown,
Yun Cao,
Rory T Buckle,
Yao Ren Liew,
Samuel S.Y. Sii,
Chiara Ventre,
Christopher Graham,
Teodora Filipescu,
Ashoor Yousif,
Reetika Dawar,
Andrea Wright,
Miriam Peters,
Rebecca Varley,
Sebastian Owczarek,
Simon Hartley,
Malak Nawaz Khan Khattak,
Atif Iqbal,
M Ali,
B Durrani,
Yajur Narang,
George Bethell,
Laura Horne,
Raquel Pinto,
Kathleen Nicholls,
Ivan Kisyov,
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Panna Patel,
M Patel,
William English,
Shan Lakhani,
S. Ashraf,
Mary L Venn,
V. Elangovan,
Zehra Kazmi,
Joanna Brecher,
Shyam Sukumar,
Adnan Mastan,
Alice Mortimer,
Jennifer Parker,
J Boyle,
M Elkawafi,
Jeffrey M. Beckett,
Ajay Mohite,
Aditya Narain,
Eshan Mazumdar,
A. Sreh,
Amy Hague,
Daniel H. Weinberg,
Laura Fletcher,
Malcolm Steel,
Hannah Shufflebotham,
Mariam Masood,
Yash Sinha,
H. Amin,
C Jenvey,
H. Kitt,
Ruth Slade,
Ashley Craig,
Ciara Deall,
Yash Sinha,
Joseph Gabriel,
T. Reakes,
Jordan V. Chervenkoff,
E Strange,
Moira K O’Bryan,
Charlotte Murkin,
D Joshi,
E Strange,
Tara Bergara,
S. Naqib,
D. Wylam,
E Strange,
S. Scotcher,
Christopher Hewitt,
Michael Stoddart,
Ashwin Kerai,
Adam Joseph Trist,
S. Cole,
Cathryn Knight,
Samuel Stevens,
Graham Cooper,
Rory Ingham,
Judith Dobson,
Joanne Wylie,
A O'Kane,
Jalal Moradzadeh,
Allyson Duffy,
C. Henderson,
S. Ashraf,
C. McLaughin,
Toby Hoskins,
R Reehal,
Lucy R. Bookless,
Ross McLean,
Emily Stone,
Esther Wright,
H Abdikadir,
Charlotte Roberts,
Olivia Spence,
Mukunthan Srikantharajah,
M Patel,
Eduardo Montero Ruiz,
J. H. Matthews,
Elizabeth C. Gardner,
Charlotte Roberts,
E. Kelly Hester,
Prasheeran,
R Simpson,
Meenu Minhas,
Emily Cornish,
SH Semnani,
Djamila Rojoa,
A Radotra,
John Eraifej,
K. Eparh,
Daniel Smith,
Bhavin Mistry,
Siobhan Hickling,
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W. Din,
C Liu,
Pryankaran Mithrakumar,
V. Mirdavoudi,
Madeeha Rashid,
Clare McGenity,
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M Kadicheeni,
Hannah Gardner,
N. Anim-Addo,
J Pearce,
Alec Aslanyan,
Chara Ntala,
T. Sorah,
J. Parkin,
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F. Edozie,
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A.G. Abdul Kahar,
V. Navayogaarajah,
Brij Patel,
D Carter,
Parisa Khonsari,
Andrea Burgess,
Brij Patel,
Chotirmall Kong,
Arachchige Ponweera,
Alex Cody,
Yi Tan,
Amelia Ng,
A. Croall,
Catherine K. Allan,
S Ng,
V Raghuvir,
Richard J. Telfer,
Arran Greenhalgh,
Caroline McKerr,
Marie Alexandra Edison,
Bhavin Patel,
K L Dear,
Myra Hardy,
P. Williams,
Shamira Hassan,
Uzma Sajjad,
Eoghan O’Neill,
Sofia Jarjour Tavares Starling Lopes,
Laura Healy,
Norhadziana Jamal,
S Tan,
D. Lazenby,
S.B. Husnoo,
Simon Beecroft,
T. Sarvanandan,
Christina G. Weston,
N Bassam,
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Umar Hayat,
Lauren C. Ng,
D. G. Varma,
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Ayesa Mian,
Amy Coates,
Al Fazir Omar,
J W Kim,
Amy Coates,
Jenardan Sellathurai,
Javed Iqbal Mahmood,
Casey L. O’Connell,
Ruma Bose,
Helen Heneghan,
Peter Lalor,
Jesse Matheson,
C C Doherty,
Caroline Cullen,
David J. Cooper,
Sophia Angelov,
C. Drislane,
Andrew Smith,
A. Kreibich,
Ebrahim Palkhi,
Andrya J. Durr,
Andrew Lotfallah,
David Gold,
Erin L. McKean,
Andrya J. Durr,
Al-Rehan Dhanji,
Anilkumar Av,
Amitabh Thacoor,
Andrya J. Durr,
Zohaib Siddiqui,
Shir-Lynn Lim,
Amand Piquet,
Shelly Anderson,
Anurag Jindal,
Darren McCormack,
Jayati Gulati,
Arwa Ibrahim,
Anurag Jindal,
Scott Murray,
Stewart Walsh,
Anika L. McGrath,
Paul Ziprin,
Eddy Chua,
Chong-yang Lou,
Joseph R. Bloomer,
Heidi Paine,
Denise Osei-Kuffour,
Carla White,
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Shyam Gokani,
Kiran Klaus Patel,
M.K. Malys,
Anthony Reed,
G.E. Torlot,
Elspeth Cumber,
Amynah Charania,
Siddique Ahmad,
Niraj Varma,
Haider R. Cheema,
L. Austreng,
H. Petra,
Muhammad Hamid Chaudhary,
Menen Zegeye,
Frances K. Cheung,
Douglas Coffey,
R. Heer,
Sweta Singh,
Emilie Seager,
S Cumming,
Rishi Suresh,
Saurabh Verma,
Imogen Ptacek,
Adam Gwozdz,
Tianqin Yang,
Ayush Khetarpal,
Syed Shumon,
Teresa Fung,
William Chun-yin Leung,
P. C. Kwang,
L S Chew,
Wayren Loke,
Alan J. Curran,
Carlos Chan,
Christine McGarrigle,
Kunal Mohan,
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Enoch Wong,
Conor Toale,
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Niamh Keane,
B P Traynor,
D. Shanahan,
Angela Yan,
Daniyal J Jafree,
C Topham,
Stefan Mitrasinovic,
Samuel O'Mara,
Buket Gundogan,
Gordon Bingham,
Panagis M. Lykoudis,
B.H. Miranda,
Katharine Whitehurst,
Geev Kumaran,
Yadsan Devabalan,
Humaira Aziz,
M. Shoa,
Shiva Dindyal,
Jonathan Yates,
Isaac A. Bernstein,
Gurender Rattan,
Jonathan Yates,
R. Coulson,
S. Stezaker,
A Isaac,
Menatalla Salem,
Angela McBride,
A Isaac,
H. McFarlane,
L. Yow,
Jonathan Macdonald,
Richard D. Bartlett,
Sanchit Turaga,
Ursula White,
Wan Jane Liew,
Nicholas H. Yim,
Andrew Ang,
Andrew Simpson,
Daniel F. McAuley,
Elaine Craig,
Lorna Murphy,
Peter Shepherd,
Jim Kee,
A Abdulmajid,
Arlene E. Chung,
Hunter Warwick,
Alana Livesey,
Patrick Holton,
Mark D Theodoreson,
S.L. Jenkin,
J. Turner,
Jonathan Entwisle,
Stéphane Marchal,
S. O'Connor,
Harry Blege,
Joanna M S Aithie,
Leh Sabine,
G.E. Stewart,
S. Jackson,
Ajit Kishore,
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Raguprakash Ratnakumaran,
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Ahmed Mohamed Abdel Shafì,
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Rupert Weaver,
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Haran Selvachandran,
Neel K. Bhatt,
S. Botchey,
Z. Khonat,
Kiva Brennan,
Kenneth Ong,
Clare Morrison,
E Devlin,
Anna Linton,
Elizabeth Galloway,
Susan McGarvie,
Norma K.C. Ramsay,
H D McRobbie,
Harriet Whewell,
William Dean,
S. Nelaj,
Mazin Eragat,
Aseem Mishra,
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Mohamed Zuhair,
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David Wilkinson,
N P Woodcock,
Elizabeth Sun,
Nora Abdul Aziz,
Momin Ghaffar
Publication year - 2016
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.10203
Subject(s) - medicine , overweight , body mass index , confidence interval , odds ratio , prospective cohort study , obesity , cohort study , complication , cohort , surgery , logistic regression , malignancy
Background There is currently conflicting evidence surrounding the effects of obesity on postoperative outcomes. Previous studies have found obesity to be associated with adverse events, but others have found no association. The aim of this study was to determine whether increasing body mass index ( BMI ) is an independent risk factor for development of major postoperative complications. Methods This was a multicentre prospective cohort study across the UK and Republic of Ireland. Consecutive patients undergoing elective or emergency gastrointestinal surgery over a 4‐month interval (October–December 2014) were eligible for inclusion. The primary outcome was the 30‐day major complication rate (Clavien–Dindo grade III –V). BMI was grouped according to the World Health Organization classification. Multilevel logistic regression models were used to adjust for patient, operative and hospital‐level effects, creating odds ratios ( ORs ) and 95 per cent confidence intervals (c.i.). Results Of 7965 patients, 2545 (32·0 per cent) were of normal weight, 2673 (33·6 per cent) were overweight and 2747 (34·5 per cent) were obese. Overall, 4925 (61·8 per cent) underwent elective and 3038 (38·1 per cent) emergency operations. The 30‐day major complication rate was 11·4 per cent (908 of 7965). In adjusted models, a significant interaction was found between BMI and diagnosis, with an association seen between BMI and major complications for patients with malignancy (overweight: OR 1·59, 95 per cent c.i. 1·12 to 2·29, P = 0·008; obese: OR 1·91, 1·31 to 2·83, P = 0·002; compared with normal weight) but not benign disease (overweight: OR 0·89, 0·71 to 1·12, P = 0·329; obese: OR 0·84, 0·66 to 1·06, P = 0·147). Conclusion Overweight and obese patients undergoing surgery for gastrointestinal malignancy are at increased risk of major postoperative complications compared with those of normal weight.