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) for predicting pulmonary embolism (PE) after gynecologic surgery. Method: The subjects were 115 female patients who underwent laparotomy for gynecologic disease. They were divided into low-dose heparin therapy (n = 28) and control, without heparin (n = 87) groups. The AFI ratio of the maximum preperitoneal fat thickness to the minimum subcutaneous fat thickness was determined using ultrasonography. Result: Post-operative PE occurred in four control patients. If the cut-off value of the AFI for predicting PE development was set at more than or equal to 0.85, the sensitivity was 1.00 and the specificity 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 hypertension [systolic blood pressure (BP) greater than or equal to 140 mmHg, diastolic BP greater than or equal to 90 mmHg or patients were taking antihypertensive medication], the sensitivity and specificity were 0.75 and 0.92, respectively (P = 0.001). Conclusion: Visceral fat obesity is a risk factor for PE after gynecologic surgery, and the AFI is useful for predicting PE and for whom post-operative low-dose heparin therapy may be indicated. (C) 2000 International Federation of Gynecology and Obstetrics.