Cardiorespiratory fitness and short-term complications after bariatric surgery.
BACKGROUND
Morbid obesity is associated with reduced functional capacity, multiple comorbidities, and higher overall mortality. The relationship between complications after bariatric surgery and preoperative cardiorespiratory fitness has not been previously studied.


METHODS
We evaluated cardiorespiratory fitness in 109 patients with morbid obesity prior to laparoscopic Roux-en-Y gastric bypass surgery. Charts were abstracted using a case report form by reviewers blinded to the cardiorespiratory evaluation results.


RESULTS
The mean age (+/- SD) was 46.0 +/- 10.4 years, and 82 patients (75.2%) were female. The mean body mass index (BMI) was 48.7 +/- 7.2 (range, 36.0 to 90.0 kg/m(2)). The composite complication rate, defined as death, unstable angina, myocardial infarction, venous thromboembolism, renal failure, or stroke, occurred in 6 of 37 patients (16.6%) and 2 of 72 patients (2.8%) with peak oxygen consumption (Vo(2)) levels < 15.8 mL/kg/min or > 15.8 mL/kg/min (lowest tertile), respectively (p = 0.02). Hospital lengths of stay and 30-day readmission rates were highest in the lowest tertile of peak Vo(2) (p = 0.005). There were no complications in those with BMI < 45 kg/m(2) or peak Vo(2) > or= 15.8 mL/kg/min. Multivariate analysis adjusting for age and gender found peak Vo(2) was a significant predictor of complications: odds ratio, 1.61 (per unit decrease); 95% confidence interval, 1.19 to 2.18 (p = 0.002).


CONCLUSIONS
Reduced cardiorespiratory fitness levels were associated with increased, short-term complications after bariatric surgery. Cardiorespiratory fitness should be optimized prior to bariatric surgery to potentially reduce postoperative complications.
McCullough
Peter A
PA
Department of Medicine, Division of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA. pmc975@yahoo.com
Gallagher
Michael J
MJ
Dejong
Adam T
AT
Sandberg
Keisha R
KR
Trivax
Justin E
JE
Alexander
Daniel
D
Kasturi
Gopi
G
Jafri
Syed M A
SM
Krause
Kevin R
KR
Chengelis
David L
DL
Moy
Jason
J
Franklin
Barry A
BA
D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010101:Oxygen Consumption / Q000502:physiology*; D010809:Physical Fitness / Q000502:physiology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology