• Dmitri Nepogodiev, Stephen J Chapman, James Glasbey, Michael Kelly, Chetan Khatri, Thomas M Drake, Chia Yew Kong, Harriet Mitchell, Ewen M Harrison, J Edward Fitzgerald, Aneel Bhangu, and STARSurg Collaborative.
• University of Birmingham, School of Cancer Sciences, Birmingham, UK.
• BMJ Open. 2015 Jan 1; 5 (7): e008811.

IntroductionObesity 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 AnalysisThis 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 DisseminationFollowing 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.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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