Martins-Filho Euclides Dias, Katz Leila, Amorim Melania, Ferraz Alvaro Antônio Bandeira, Ferraz Edmundo Machado
Bariatric Surgery Unit of the General Surgery Division of the University Hospital of The Federal University of Pernambuco (UFPE), Recife, PE, Brasil.
Arq Gastroenterol. 2011 Jan-Mar;48(1):8-14. doi: 10.1590/s0004-28032011000100003.
Superobese patients who undergo gastric bypass have a greater incidence of complications. The greater incidence of comorbidity in this group leads to a higher surgical risk, and a need for special care. By analyzing the risk factors identified in the preoperative period, scoring them, constructing a score and assessing the occurrence of serious complications and death, we will have elements to identify which patients are at greater risk.
To determine the accuracy of the Recife Score for predicting serious postoperative complications and death in superobese patients who undergo Roux-en-Y gastric bypass surgery by the conventional method.
An ambidirectional study was conducted to validate the diagnostic test on 203 severely obese patients submitted to Roux-en-Y gastric bypass at the Hospital das Clínicas of the Federal University of Pernambuco, Recife, PE, Brazil, from September 1997 to May 2007. The dependent variables were major postoperative complications and death. The independent variable was the Recife Score. The data were analyzed using the Epi-Info 3.5.1 program. The accuracy of the Recife Score was analyzed considering the following parameters: sensitivity, specificity, positive predictive value, negative predictive value, positive verisimilitude ratio and negative verisimilitude ratio.
The accuracy of the Recife Score with cut-off points higher than 3 and higher than 5 to predict serious postoperative complications was, respectively, a frequency of complications of 12.3%, with a risk ratio of 2.83, sensitivity of 57.1% and specificity of 69.8%, and 12.5%, with a risk ratio of 1.88, sensitivity of 7.1% and specificity of 96.3%. The accuracy of the Recife Score with cut-off points higher than 3 and higher than 5 to predict death was, respectively, a frequency of death of 7.7%, with a risk ratio of 10.62, sensitivity of 83.3% and specificity of 69.5%, and 12.5%, with a risk ratio of 4.88, sensitivity of 16.7% and specificity of 96.5%.
A Recife Score >3 prior to conventional gastric bypass presents a high level of accuracy in the prediction of serious postoperative complications and death.
接受胃旁路手术的超级肥胖患者并发症发生率更高。该群体中合并症发生率更高导致手术风险更高，且需要特殊护理。通过分析术前确定的风险因素、对其进行评分、构建一个分数并评估严重并发症和死亡的发生情况，我们将获得一些要素来识别哪些患者风险更高。
通过传统方法确定累西腓评分在预测接受 Roux - Y 胃旁路手术的超级肥胖患者术后严重并发症和死亡方面的准确性。
进行了一项双向研究，以验证对 203 例重度肥胖患者的诊断测试，这些患者于 1997 年 9 月至 2007 年 5 月在巴西伯南布哥累西腓联邦大学临床医院接受 Roux - Y 胃旁路手术。因变量是术后主要并发症和死亡。自变量是累西腓评分。使用 Epi - Info 3.5.1 程序分析数据。考虑以下参数分析累西腓评分的准确性：敏感性、特异性、阳性预测值、阴性预测值、阳性似然比和阴性似然比。
累西腓评分在截断点高于 3 和高于 5 时预测术后严重并发症的准确性分别为：并发症发生率为 12.3%，风险比为 2.83，敏感性为 57.1%，特异性为 69.8%；以及 12.5%，风险比为 1.88，敏感性为 7.1%，特异性为 96.3%。累西腓评分在截断点高于 3 和高于 5 时预测死亡的准确性分别为：死亡率为 7.7%，风险比为 10.62，敏感性为 83.3%，特异性为 69.5%；以及 12.5%，风险比为 4.88，敏感性为 16.7%，特异性为 96.5%。
在传统胃旁路手术前，累西腓评分>3 在预测术后严重并发症和死亡方面具有较高的准确性。
