Preoperative factors predictive of complicated postoperative management after Roux-en-Y gastric bypass for morbid obesity

• DOI: 10.1007/s00464-003-8810-9
• Publication Date: 2004-02-09T16:18:16Z
• Authors: R. Gonzalez; S. P. Bowers; K. R. Venkatesh; E. Lin; C. D. Smith
• Keywords: Adult; Male; Gastric Bypass; Comorbidity; Body Mass Index; Electrocardiography; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Risk Factors; Forced Expiratory Volume; Sepsis; Humans; Prospective Studies; 2. Zero hunger; Anastomosis, Roux-en-Y; Middle Aged; Respiration Disorders; Obesity, Morbid; 3. Good health; Cardiovascular Diseases; Kidney Failure, Chronic; Female; Gastrointestinal Hemorrhage

This study was undertaken to determine preoperative predictive factors of complicated postoperative management after Roux-en-Y gastric bypass (RYGB) for morbid obesity.Between January 1999 and January 2002, 158 patients who underwent a RYGB received a standardized preoperative evaluation and data were collected prospectively. Complicated postoperative management was defined as patients requiring postoperative ICU admission for > or =48 h, or those needing transfer from the floor to the ICU. Patients with complicated management were compared with those in whom ICU admission was not necessary.Twenty-three patients (14.5%) required prolonged ICU admission (mean stay of 6.3 +/- 1.7 days). After multivariate analysis, body mass index (BMI) >50 kg/m2, forced expiratory volume (FEV1) <80% predicted, previous abdominal surgeries, and abnormal EKG were found to be independently associated with an increased likelihood of complicated postoperative care.BMI >50 kg/m2, FEV1 <80% predicted, previous abdominal surgeries, and abnormal EKG increase the likelihood of complicated postoperative management after RYGB for morbid obesity.