Preoperative factors predictive of complicated postoperative management after Roux-en-Y gastric bypass for morbid obesity.
BACKGROUND
This study was undertaken to determine preoperative predictive factors of complicated postoperative management after Roux-en-Y gastric bypass (RYGB) for morbid obesity.


METHODS
Between January 1999 and January 2002, 158 patients who underwent a RYGB received a standardized preoperative evaluation and data were collected prospectively. Complicated postoperative management was defined as patients requiring postoperative ICU admission for > or =48 h, or those needing transfer from the floor to the ICU. Patients with complicated management were compared with those in whom ICU admission was not necessary.


RESULTS
Twenty-three patients (14.5%) required prolonged ICU admission (mean stay of 6.3 +/- 1.7 days). After multivariate analysis, body mass index (BMI) >50 kg/m2, forced expiratory volume (FEV1) <80% predicted, previous abdominal surgeries, and abnormal EKG were found to be independently associated with an increased likelihood of complicated postoperative care.


CONCLUSIONS
BMI >50 kg/m2, FEV1 <80% predicted, previous abdominal surgeries, and abnormal EKG increase the likelihood of complicated postoperative management after RYGB for morbid obesity.
Gonzalez
R
R
Emory Bariatrics and Endosurgery Unit, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322, USA.
Bowers
S P
SP
Venkatesh
K R
KR
Lin
E
E
Smith
C D
CD
D000328:Adult; D000713:Anastomosis, Roux-en-Y; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D004562:Electrocardiography; D005260:Female; D005541:Forced Expiratory Volume; D015390:Gastric Bypass / Q000706:statistics & numerical data*; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology; D013529:Surgical Wound Dehiscence / Q000453:epidemiology