title: [Is obesity a risk factor for complications, hospital admissions, and surgical cancellations in ambulatory surgery?].
abstract: OBJECTIVE
  To determine the incidence of outcomes, unanticipated admissions and cancellations in patients operated in an Ambulatory surgery unit, and to establish the relationships with their body mass index (BMI).
  
  
  METHODS
  An observational descriptive prospective study was conducted in the Ambulatory surgery unit of the University Hospital Virgen del Rocío of Seville, on ASA I or II adult patients proposed for day case surgery with loco-regional or general anesthesia. A cohort of 1,088 patients was classified according to their body mass index into four groups: no obesity (BMI<30), obesity i (BMI 30-34.9), obesity ii (BMI 35-39.9), and morbid obesity iii (BMI 40-49.9). Postoperative outcomes (48h), inpatient admissions, and cancellations where calculated.
  
  
  RESULTS
  The obesity ii (BMI 35-39.9) group showed a higher incidence of postoperative complications (7.69%), unplanned admissions (7.69%), and surgical cancellations (4.87%), doubling, at least, the incidence of adverse events of the other study groups, even when no significant difference was found. Outcomes where similar in all study groups.
  
  
  CONCLUSIONS
  The results of this study suggest that moderate and severe obesity should be a risk factor for postoperative complications, unplanned admissions, and cancellations in outpatient surgery. Adequate patient selection and preoperative evaluation, as well as strategies for the prevention and control of the most frequents complications in obese patients are the key factors for their integration in major ambulatory surgery programs.
authors.affiliation: Servicio de Anestesiología y Reanimación, Unidad de Cirugía Mayor Ambulatoria, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: malenarance@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Arance García
authors.affiliation: Servicio de Cirugía General, Unidad de Cirugía Mayor Ambulatoria, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: F
authors.initials: F
authors.lastname: Docobo Durántez
authors.affiliation: Servicio de Urgencias, Hospital Juan Ramón Jiménez, Huelva, España.
authors.forename: C
authors.initials: C
authors.lastname: Conde Guzmán
authors.affiliation: Servicio de Anestesiología y Reanimación, Unidad de Cirugía Mayor Ambulatoria, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: M C
authors.initials: MC
authors.lastname: Pérez Torres
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Virgen de la Arrixaca, Murcia, España.
authors.forename: R
authors.initials: R
authors.lastname: Martín-Gil Parra
authors.affiliation: Servicio de Anestesiología y Reanimación, Unidad de Cirugía Mayor Ambulatoria, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: P E
authors.initials: PE
authors.lastname: Fernández Jiménez
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000150:complications*; D010343:Patient Admission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors
keywords: Body mass index; Cancellations; Cirugía mayor ambulatoria; Complicaciones postoperatorias; Ingreso no esperado; Obesidad; Obesity; Outpatient surgery; Postoperative complications; Suspensiones quirúrgicas; Unanticipated admission; Índice de masa corporal