Obesity associated risk using Edmonton staging in bariatric surgery

• Published in: Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral Vol. 31; no. 1; pp. 196 - 202
• Main Authors: de Cos, Ana Isabel, Cardenas, Jersy J, Pelegrina, Beatriz, Roldan, M Concepción, Calvo, Isabel, Vázquez, Clotilde, Pallardo, Luis Felipe
• Format: Journal Article
• Language: Spanish
• Published: Spain 20-09-2014
• Subjects: Adolescent; Adult; Aged; Bariatric Surgery - statistics & numerical data; Body Mass Index; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - etiology; Female; Gastroesophageal Reflux - epidemiology; Gastroesophageal Reflux - etiology; Humans; Male; Middle Aged; Obesity, Morbid - complications; Obesity, Morbid - epidemiology; Obesity, Morbid - surgery; Predictive Value of Tests; Risk Assessment; Sleep Apnea Syndromes - epidemiology; Sleep Apnea Syndromes - etiology; Spain - epidemiology; Young Adult
• ISSN: 1699-5198
• DOI: 10.3305/nh.2015.31.1.8097

With a prevalence of Morbid Obesity of 1,2% of the Spanish population, the current criteria for Bariatric Surgery do not classify patients taking into consideration co-morbidities or functional status. We need new staging systems useful in predicting mortality and able to support prioritizing treatments.
Applying Edmonton staging system to patients awaiting Bariatric Surgery.
Data collected from 81 patients from 2011- 2013 after pre-surgery protocol. Weight, height, waist, BMI, biochemical parameters and blood pressure are registered. Also taken down are hepatic, renal, osteoarticular diseases, sleep-apnea syndrome and/or gastro-oesophageal reflux, if present. Edmonton staging of ten variables is applied to each patient.
81 patients: 67% women, average age 47y, 18% below 30y. Average BMI of 47, 90% of patients have a BMI >40. 34% of patients show sleep-apnea syndrome and 25% gastro-oesophageal reflux. 9% of the patients have a BMI >45, diabetes mellitus and sleep-apnea syndrome. Applying the Edmonton Staging, nine patients (11%) are in the highest risk range (stage 3), 70% are in the high-risk range (stage 2) and 15 patients (18%) are included in the low-risk range. No patient was found to be in stage 0 without obesity risk factors.
The Edmonton staging system provides us with information on presence or extent of co-morbidities that guide decision making in individuals. The mortality- predictive ability of Edmonton proposal could help to assist in determining the urgency of Bariatric Surgery and establish better criteria to prioritize these group of patients.