Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Surg Endosc. 2020 Jul;34(7):3102-3109. doi: 10.1007/s00464-019-07067-4. Epub 2019 Aug 27.
The Edmonton Obesity Staging System (EOSS) is a staging system describing comorbidities and functional limitations associated with obesity, thus facilitating the prioritization of patients for bariatric surgery. Our objective was to elucidate any associations of EOSS scores with major complications after laparoscopic Roux-en-Y gastric bypass (LRYGB).
A retrospective chart review examined patients who received primary LRYGB from 2009 to 2015 at a single center. Collected data included patient comorbidities, preoperative EOSS stage, body mass index (BMI), age, percent excess weight loss, and 1-year major complications. Major complications were defined by a Clavien-Dindo classification ≥ IIIa.
378 patients (81.7% female) receiving primary LRYGB were reviewed with the following EOSS stages: 0 (3.7%), 1 (10.8%), 2 (78.6%), 3 (6.9%), and 4 (0.0%). The mean preoperative BMI was 45.9 (SD 6.3) kg/m. The overall major complication rate was 9.3%. Major complication rates for EOSS stages 0, 1, 2, and 3 were 7.1%, 4.9%, 8.8%, and 23.1%, respectively. Follow-up rates at 12 months were 76.6% with a mean overall follow-up of 10.9 (2.1) months. Multivariable analysis showed that patients undergoing LRYGB with an EOSS of 3 were more likely to experience major complications (OR 2.94; CI 1.04 to 8.35, p = 0.043).
Our findings suggest that undergoing LRYGB with EOSS stage 3 has increased odds of major complications. As such, the EOSS demonstrates utility in identifying bariatric surgery candidates at risk of major postoperative morbidity. Further studies are required to assess the applicability of the EOSS for patients undergoing other forms of bariatric surgery.
埃德蒙顿肥胖分期系统（EOSS）是一种描述肥胖相关合并症和功能障碍的分期系统，有助于为减重手术患者进行优先级排序。我们的目的是阐明 EOSS 评分与腹腔镜 Roux-en-Y 胃旁路术（LRYGB）后主要并发症之间的任何关联。
回顾性图表审查检查了 2009 年至 2015 年在一家单中心接受原发性 LRYGB 的患者。收集的数据包括患者合并症、术前 EOSS 分期、体重指数（BMI）、年龄、超重百分比减轻和 1 年主要并发症。主要并发症的定义为 Clavien-Dindo 分类≥IIIa。
共回顾了 378 例（81.7%为女性）接受原发性 LRYGB 的患者，EOSS 分期如下：0（3.7%）、1（10.8%）、2（78.6%）、3（6.9%）和 4（0.0%）。术前 BMI 平均为 45.9（SD 6.3）kg/m。总的主要并发症发生率为 9.3%。EOSS 分期 0、1、2 和 3 的主要并发症发生率分别为 7.1%、4.9%、8.8%和 23.1%。12 个月时的随访率为 76.6%，平均总随访时间为 10.9（2.1）个月。多变量分析显示，EOSS 为 3 的患者接受 LRYGB 更有可能发生主要并发症（OR 2.94；CI 1.04 至 8.35，p=0.043）。
我们的研究结果表明，EOSS 分期 3 的 LRYGB 术后发生主要并发症的几率更高。因此，EOSS 有助于识别有术后高发病率风险的减重手术候选者。需要进一步研究来评估 EOSS 对接受其他形式减重手术的患者的适用性。
