Preanesthetic clinical problems of morbidly obese patients submitted to bariatric surgery: comparison with non-obese patiens.
OBJECTIVE
Morbid obesity is associated to clinical problems responsible for decreased life expectancy. Morbidly obese patients are candidates to gastric bypass and pose new challenges to the anesthesiologist. This study compared the prevalence of clinical problems among morbidly obese patients submitted to bariatric surgery to non-obese patients submitted to other elective surgical procedures.


METHODS
Electronic records of 2986 patients were retrospectively studied. Patients were divided in two groups; 1: patients with morbid obesity submitted to bariatric surgeries; and group 2: non obese patients (body mass index less than 30 kg m(-2)), submitted to other elective surgical procedures. Groups were matched according to age, gender and ASA physical status. Preanesthetic problems common to group 1 were investigated in group 2, and prevalence was compared. Odds ratios and 95% confidence limits were calculated.


RESULTS
Clinical problems identified in groups 1 and 2 and their respective prevalence were: gastroesophageal reflux (16.67% and 0.48%), systemic hypertension (50% and 3.06%), type II diabetes mellitus (6.25% and 0.31%), hypothyroidism (6.25% and 0.31%), bronchial asthma (10.42% and 1.43%) and restrictive lung disease (10.42% and 0.03%). Incidences were significantly higher in group 1. Additionally, the following problems were found in group 1, but not in group 2: epilepsy (2.08%), nonalcoholic fatty liver (12.5%), gall bladder stones (6.25%), dyslipemia (20.83%) and hypopytuitarism (2.08%).


CONCLUSIONS
The prevalence of clinical problems was significantly higher in morbidly obese patients as compared to their non-obese counterparts.
de Oliveira Filho
Getúlio Rodrigues
GR
Hospitais de Caridade e Governador Celso Ramos, CET/SBA Integrado de Anestesiologia da SES-SC, Florianópolis, SC. grof@th.com.br
Nicolodi
Tânia Helena Carnieleto
TH
Garcia
Jorge Hamilton Soares
JH
Nicolodi
Marcos Antônio
MA
Goldschmidt
Ranulfo
R
Dal Mago
Adilson José
AJ