After controlling for confounders , extremely obese patients had a twofold to fourfold increase in postoperative complications , including the primary infectious outcome ( 18.8 % , adjusted OR 2.7 , CI 1.2-6 .1 ) , wound infection ( 18.8 % , adjusted OR 3.4 , CI 1.4-8 .0 ) , and emergency department visit ( 23.1 % , adjusted OR 2.2 , CI 1.03-4 .9 ) .