Chiappetta Sonja, Stier Christine, Squillante Simone, Theodoridou Sophia, Weiner Rudolf A
Department of Obesity and Metabolic Surgery, Sana Klinikum Offenbach, Offenbach am Main, Germany.
Department of Obesity and Metabolic Surgery, Sana Klinikum Offenbach, Offenbach am Main, Germany.
Surg Obes Relat Dis. 2016 Dec;12(10):1847-1855. doi: 10.1016/j.soard.2016.02.042. Epub 2016 Mar 2.
The Edmonton Obesity Staging System (EOSS) is a more comprehensive measure of obesity-related diseases and predictor of mortality than body mass index (BMI) or waist circumference. Its application for the selection of obese patients for obesity surgery has been suggested.
The aim of this study was to determine whether the EOSS can also be used in predicting postoperative outcome and 30-day mortality after metabolic surgery.
Center of maximum care in Germany METHODS: We collected data prospectively for patients undergoing laparoscopic sleeve gastrectomy (LSG), laparoscopic Roux-en-Y gastric bypass (LRYGB), or laparoscopic omega-loop gastric bypass (LOLGB). The data collected included preoperative EOSS score, gender, age, BMI, waist circumference, waist-to-hip ratio, co-morbidities, early postoperative complications, and 30-day mortality.
A total of 534 patients were included. The mean BMI was 45.57 kg/m (range 35-64.5) for LRYGB patients (n = 168), 53.27 kg/m (range 35.1-82.1) for LSG patients (n = 282), and 49.42 kg/m (range 36-73.1) for LOLGB patients (n = 84). The total postoperative complication rate was 8.99%. The most common EOSS stage was 2 (70.6% of patients), followed by stages 3 (12.55%), 1 (11.61%), and 0 (5.06%). The postoperative complication rates after LRYGB, LSG, and LOLGB were 0% for EOSS 0 and 1.61% for EOSS 1. The postoperative complication rates were 8.22% for EOSS 2 and 22.39% for EOSS 3.
Patients with EOSS≥3 have a higher risk of postoperative complications. Our data confirm that the EOSS is useful as a scoring system for the selection of obese patients before surgery and suggest that it may also be useful for presurgical stratification and risk assessment in clinical practice. Patients should be recommended for obesity surgery when their EOSS stage is 2 to prevent impairments associated with metabolic disease and to reduce the risk of postoperative complications.
与体重指数（BMI）或腰围相比，埃德蒙顿肥胖分期系统（EOSS）是一种更全面的肥胖相关疾病测量方法和死亡率预测指标。有人建议将其应用于肥胖手术患者的选择。
本研究的目的是确定EOSS是否也可用于预测代谢手术后的术后结局和30天死亡率。
德国重症监护中心
我们前瞻性地收集了接受腹腔镜袖状胃切除术（LSG）、腹腔镜Roux-en-Y胃旁路术（LRYGB）或腹腔镜ω-袢胃旁路术（LOLGB）患者的数据。收集的数据包括术前EOSS评分、性别、年龄、BMI、腰围、腰臀比、合并症、术后早期并发症和30天死亡率。
共纳入534例患者。LRYGB患者（n = 168）的平均BMI为45.57kg/m²（范围35 - 64.5），LSG患者（n = 282）为53.27kg/m²（范围35.1 - 82.1），LOLGB患者（n = 84）为49.42kg/m²（范围36 - 73.1）。术后总并发症发生率为8.99%。最常见的EOSS分期为2期（70.6%的患者），其次是3期（12.55%）、1期（11.61%）和0期（5.06%）。EOSS 0期和1期的LRYGB、LSG和LOLGB术后并发症发生率为0%，EOSS 2期为8.22%，EOSS 3期为22.39%。
EOSS≥3的患者术后并发症风险较高。我们的数据证实，EOSS作为术前选择肥胖患者的评分系统是有用的，并表明它在临床实践中可能也有助于术前分层和风险评估。当患者的EOSS分期为2期时，应建议其进行肥胖手术，以预防与代谢疾病相关的损害并降低术后并发症风险。
