Use of the abdominal wall fat index determined ultrasonographically for assessing the risk of post-operative pulmonary embolism

Objective: To assess the usefulness of the abdominal wall fat index (AFI) f or predicting pulmonary embolism (PE) after gynecologic surgery. Method: Th e subjects were 115 female patients who underwent laparotomy for gynecologi c disease. They were divided into low-dose heparin therapy (n = 28) and con trol, without heparin (n = 87) groups. The AFI ratio of the maximum preperi toneal fat thickness to the minimum subcutaneous fat thickness was determin ed using ultrasonography. Result: Post-operative PE occurred in four contro l patients. If the cut-off value of the AFI for predicting PE development w as set at more than or equal to 0.85, the sensitivity was 1.00 and the spec ificity was 0.60 (P = 0.03). If we restricted the criteria, and set the cut -off value of the AFI to more than or equal to 0.85 in patients with hypert ension [systolic blood pressure (BP) greater than or equal to 140 mmHg, dia stolic BP greater than or equal to 90 mmHg or patients were taking antihype rtensive medication], the sensitivity and specificity were 0.75 and 0.92, r espectively (P = 0.001). Conclusion: Visceral fat obesity is a risk factor for PE after gynecologic surgery, and the AFI is useful for predicting PE a nd for whom post-operative low-dose heparin therapy may be indicated. (C) 2 000 International Federation of Gynecology and Obstetrics.