Fitness level affects bariatric surgery outcomes

Morbidly obese patients with poor cardiopulmonary fitness may experience increased complications after bariatric surgery. New research published in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), shows that bariatric surgery patients with low cardiopulmonary fitness levels experienced longer operative times and suffered more postsurgery complications than patients with higher fitness levels. Bariatric surgery, a procedure that involves surgically shrinking the stomach in order to limit food intake, is associated with sustained weight reduction in the morbidly obese.

"Random complications may occur during bariatric surgery," said Peter A. McCullough, MD, MPH, William Beaumont Hospital, Royal Oak, MI. "However, complications may become more apparent in patients with low levels of cardiopulmonary fitness, because they have very little pulmonary reserve and have reduced ability to withstand surgery."

Dr. McCullough and colleagues evaluated the relationship between cardiopulmonary fitness and other clinical variables and postoperative complications after bariatric surgery. Included in the study were 109 morbidly obese patients (75.2 percent women) with a mean body mass index (BMI) of 48.7 7.2. Patients were divided into tertiles, with the first tertile having the highest BMI and lowest cardiopulmonary fitness and the third tertile had the lowest BMI and highest cardiopulmonary fitness.

All patients underwent bariatric surgery (laparoscopic Roux-en-Y gastric bypass surgery), and outcomes were organized into intermediate (operative and reversible), primary (permanent or potential organ damage), and secondary (length of stay and readmission). Overall, patients in the first tertile were seven times more likely to experience primary complications than patients in the next two tertiles. In the first tertile, 16.6 percent of patients experienced primary complications, including death, un

Contact: Jennifer Stawarz
American College of Chest Physicians

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