Comparative analysis of respiratory muscle strength before and after bariatric surgery using 5 different predictive equations.
OBJECTIVE
Obesity has detrimental effects on general health and respiratory function. This study aimed to evaluate respiratory muscle strength in the morbidly obese population, before and after bariatric surgery, and to compare these estimates with the predictive values using different mathematical equations available.


METHODS
Prospective cohort study.


METHODS
Outpatient clinic for the treatment of obesity.


METHODS
Patients scheduled for elective bariatric surgery.


METHODS
Bariatric surgery.


METHODS
The maximal inspiratory pressure (MIP) was measured at screening and 3, 6, and 9 months postoperative. Predictive values were calculated using 5 different mathematical equations. Visual inspection of Bland-Altman plots was performed to determine the agreement between the equations studied.


RESULTS
In total 125 patients were found eligible and 122 patients were available for the final analysis, among them were 104 women and 18 men, with a mean age of 43.02 ± 11.11 years and mean BMI of 43.10 ± 5.25 kg/m(2). In the preoperative period, the predicted MIPs according to the Harik-Khan, Neder, Costa, and Wilson equations were significantly different compared with the actual MIP (P < .05). The predicted MIP according to the Enright equation was not significantly different (P > .05). Postoperatively, there was a significant difference between the MIP values after 3 and 6 months and the predicted MIP values according to Harik Khan, Neder, and Enright equations. After 9 months, all predicted MIP values were significantly different from the predicted values. Bland-Altman analysis showed that the Enright equation was best suitable for predicting the MIP.


CONCLUSIONS
Of the 5 mathematical equations studied, that of Enright and colleagues was found best suitable for predicting the MIP in the obese population studied.
Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, the Netherlands. Electronic address: sjaak.pouwels@catharinaziekenhuis.nl.
Sjaak
S
Pouwels
Department of Anesthesiology, Catharina Hospital, Eindhoven, the Netherlands.
Marc P
MP
Buise
Department of Respiratory Medicine, Catharina Hospital, Eindhoven, the Netherlands; SHE School of Health Professions Education, Maastricht University, Maastricht, the Netherlands.
Frank W J M
FW
Smeenk
Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Department of Epidemiology, CAPHRI Research School, Maastricht University, Maastricht, the Netherlands.
Joep A W
JA
Teijink
Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
Simon W
SW
Nienhuijs
D000328:Adult; D050110:Bariatric Surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D009767:Obesity, Morbid / Q000601:surgery*; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D012132:Respiratory Muscles / Q000502:physiology*
Bariatric surgery; Inspiratory pressure; Predictive equations; Respiratory muscle strength