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Determining Surgical Complications in the Overweight (DISCOVER): a multicentre observational cohort study to evaluate the role of obesity as a risk factor for postoperative complications in general surgery
  1. Dmitri Nepogodiev1,
  2. Stephen J Chapman2,
  3. James Glasbey3,
  4. Michael Kelly4,
  5. Chetan Khatri5,
  6. Thomas M Drake6,
  7. Chia Yew Kong7,
  8. Harriet Mitchell8,
  9. Ewen M Harrison9,
  10. J Edward Fitzgerald10,
  11. Aneel Bhangu11
  12. on behalf of the STARSurg Collaborative
  1. 1University of Birmingham, School of Cancer Sciences, Birmingham, UK
  2. 2St James University Hospital, Leeds, UK
  3. 3University Hospital of Wales, Cardiff, UK
  4. 4Aintree University Hospital, Liverpool, UK
  5. 5Imperial College London Medical School, London, UK
  6. 6University of Sheffield Medical School, Sheffield, UK
  7. 7University of Glasgow Medical School, Glasgow, UK
  8. 8University of Bristol Medical School, Bristol, UK
  9. 9Department of Surgery, University of Edinburgh, Edinburgh, UK
  10. 10University College London, London, UK
  11. 11University of Birmingham, School of Cancer Sciences, Birmingham, UK
  1. Correspondence to Dr J Edward Fitzgerald; jeffitzgerald{at}


Introduction Obesity is increasingly prevalent among patients undergoing surgery. Conflicting evidence exists regarding the impact of obesity on postoperative complications. This multicentre study aims to determine whether obesity is associated with increased postoperative complications following general surgery.

Methods and analysis This prospective, multicentre cohort study will be performed utilising a collaborative methodology. Consecutive adults undergoing open or laparoscopic, elective or emergency, gastrointestinal, bariatric or hepatobiliary surgery will be included. Day case patients will be excluded. The primary end point will be the overall 30-day major complication rate (Clavien-Dindo grade III–V complications). Data will be collected to risk-adjust outcomes for potential confounding factors, such as preoperative cardiac risk. This study will be disseminated through structured medical student networks using established collaborative methodology. The study will be powered to detect a two-percentage point increase in the major postoperative complication rate in obese versus non-obese patients.

Ethics and dissemination Following appropriate assessment, an exemption from full ethics committee review has been received, and the study will be registered as a clinical audit or service evaluation at each participating hospital. Dissemination will take place through national and local research collaborative networks.


This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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