de Cos Ana Isabel, Cardenas Jersy J, Pelegrina Beatriz, Roldan M Concepción, Calvo Isabel, Vázquez Clotilde, Pallardo Luis Felipe
Unidad de Obesidad, Servicio de Endocrinología y Nutrición..
Hospital Universitario La Paz. Fundación Jimenez Díaz, Madrid. España..
Nutr Hosp. 2014 Sep 20;31(1):196-202. 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.
西班牙人群中病态肥胖的患病率为1.2%,目前的减肥手术标准在对患者进行分类时未考虑合并症或功能状态。我们需要新的分期系统,以预测死亡率并支持确定治疗的优先顺序。
将埃德蒙顿分期系统应用于等待减肥手术的患者。
收集2011年至2013年81例患者术前方案的数据。记录体重、身高、腰围、体重指数、生化参数和血压。还记录是否存在肝脏、肾脏、骨关节疾病、睡眠呼吸暂停综合征和/或胃食管反流。对每位患者应用十个变量的埃德蒙顿分期。
81例患者:67%为女性,平均年龄47岁,18%年龄在30岁以下。平均体重指数为47, 90%的患者体重指数>40。34%的患者患有睡眠呼吸暂停综合征,25%患有胃食管反流。9%的患者体重指数>45,患有糖尿病和睡眠呼吸暂停综合征。应用埃德蒙顿分期,9例患者(11%)处于最高风险范围(3期),70%处于高风险范围(2期),15例患者(18%)处于低风险范围。未发现无肥胖风险因素的患者处于0期。
埃德蒙顿分期系统为我们提供了有关合并症存在或程度的信息,可以指导个体的决策。埃德蒙顿方案预测死亡率的能力有助于确定减肥手术的紧迫性,并建立更好的标准来确定这些患者群体的优先顺序。