title: Obese patients: respiratory complications in the post-anesthesia care unit.
abstract: BACKGROUND
  Obesity has been associated with respiratory complications, and the majority of these complications occur in the Post-Anesthesia Care Unit (PACU). The aim of this study was to evaluate the outcome and incidence of adverse respiratory events (AREs) in obese patients during their stay in the PACU METHODS: We conducted a prospective control study that included 27 obese patients matched with an equal number of patients with body mass index (BMI)<30 (non-obese control group); the 2 groups of patients were similar in respect to gender distribution, age, and type of surgery and had been admitted into the PACU after elective surgery (May 2011). The AREs were identified during PACU stay. Descriptive analysis of variables was performed, and the Mann-Whitney U test, Chi-square test, or Fisher's exact test were used for comparisons. Associations with AREs were studied using univariate and multivariate logistic regression models.
  
  
  RESULTS
  There was a higher frequency of STOP-BANG ≥3 (89% vs. 11%, P<.001) among obese patients and they were less frequently scheduled to undergo high-risk surgery (7% vs. 41%, P=.005) and major surgery (4% vs. 15%, P=.008). Obese patients had more frequent AREs in the PACU (33% vs. 7%, P<.018). Multivariate analysis identified obesity and residual neuromuscular blockade as independent risk factors for the occurrence of AREs. Stay in the PACU was longer for obese patients (120min vs. 84min, P<.01).
  
  
  CONCLUSIONS
  Obesity was considered an independent risk factor for AREs in the PACU. Obese patients stayed longer in the PACU, but they did not stay longer in the hospital.
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Mendonça
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: H
authors.initials: H
authors.lastname: Pereira
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: D
authors.initials: D
authors.lastname: Xará
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Santos
authors.affiliation: Serviço de Anestesiologia, Centro Hospitalar de São João, Porto, Portugal; Unidade de Anestesiologia e Cuidados Peri-operatórios, Departamento de Cirurgia da Faculdade de Medicina, Universidade do Porto, Porto, Portugal. Electronic address: fernando.abelha@gmail.com.
authors.forename: F J
authors.initials: FJ
authors.lastname: Abelha
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012120:Respiration Disorders / Q000209:etiology*
keywords: Body mass index; Eventos respiratórios; Obesidade; Obesity; Postoperative outcome; Respiratory events; Resultados pós-operatórios; Índice de massa corporal