TY - JOUR
T1 - Factors affecting morbidity and mortality of roux-en-Y gastric bypass for clinically severe obesity
T2 - An analysis of 1,000 consecutive open cases by a single surgeon
AU - Flancbaum, Louis
AU - Belsley, Scott
PY - 2007/4
Y1 - 2007/4
N2 - Determinants of perioperative risk for RYGB are not well defined. Retrospective analysis of comorbidities was used to evaluate predictors of perioperative risk in 1,000 consecutive patients having open RYGB by univariate analyses and logistic regression. One hundred forty-six men, 854 women; average age 38.3∈±∈11.2 years; mean BMI 51.8∈±∈10.5 (range 24-116) were evaluated. Average hospital stay (LOS) was 3.8 days; 87% <3 days. 91.3% of procedures were without major complication. The most common complications were incisional hernia 3.5%, intestinal obstruction 1.9%, and leak 1.6%. 31 patients required reoperation within 30 days (3.1%). A 30-day mortality was 1.2%. Logistic regression evaluating predictors of operative mortality correlated strongly with coronary artery disease (CAD) (p∈<∈0.01), sleep apnea (p∈=∈0.03), and age (p∈=∈0.042). BMI∈>∈50 (0.6 vs 2.3%, p∈=∈0.03) and male sex were associated with increased mortality (1.3 vs. 4.0%, p∈=∈0.02). Sex-specific logistic regression demonstrated males with angiographically proven CAD were more likely to die (p∈=∈0.028) than matched cohorts. Age (p∈=∈0.033) and sleep apnea (p∈=∈0.040) were significant predictors of death for women. Perioperative mortality after RYGB appears to be affected by sex, BMI, age, CAD, and sleep apnea. Strategies employing risk stratification should be developed for bariatric surgery. .
AB - Determinants of perioperative risk for RYGB are not well defined. Retrospective analysis of comorbidities was used to evaluate predictors of perioperative risk in 1,000 consecutive patients having open RYGB by univariate analyses and logistic regression. One hundred forty-six men, 854 women; average age 38.3∈±∈11.2 years; mean BMI 51.8∈±∈10.5 (range 24-116) were evaluated. Average hospital stay (LOS) was 3.8 days; 87% <3 days. 91.3% of procedures were without major complication. The most common complications were incisional hernia 3.5%, intestinal obstruction 1.9%, and leak 1.6%. 31 patients required reoperation within 30 days (3.1%). A 30-day mortality was 1.2%. Logistic regression evaluating predictors of operative mortality correlated strongly with coronary artery disease (CAD) (p∈<∈0.01), sleep apnea (p∈=∈0.03), and age (p∈=∈0.042). BMI∈>∈50 (0.6 vs 2.3%, p∈=∈0.03) and male sex were associated with increased mortality (1.3 vs. 4.0%, p∈=∈0.02). Sex-specific logistic regression demonstrated males with angiographically proven CAD were more likely to die (p∈=∈0.028) than matched cohorts. Age (p∈=∈0.033) and sleep apnea (p∈=∈0.040) were significant predictors of death for women. Perioperative mortality after RYGB appears to be affected by sex, BMI, age, CAD, and sleep apnea. Strategies employing risk stratification should be developed for bariatric surgery. .
KW - Morbid obesity
KW - Morbidity
KW - Mortality
KW - Obesity
KW - Roux-en-Y gastric bypass
UR - http://www.scopus.com/inward/record.url?scp=34250636312&partnerID=8YFLogxK
U2 - 10.1007/s11605-007-0117-z
DO - 10.1007/s11605-007-0117-z
M3 - Article
C2 - 17436136
AN - SCOPUS:34250636312
SN - 1091-255X
VL - 11
SP - 500
EP - 507
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 4
ER -