Document Detail

Extensive preoperative testing is not necessary in morbidly obese patients undergoing gastric bypass.
MedLine Citation:
PMID:  15036191     Owner:  NLM     Status:  MEDLINE    
Morbidly obese patients are considered at high risk for perioperative complications and often undergo extensive testing for preoperative clearance. We analyzed prospectively collected data from 193 patients undergoing weight loss surgery between November 2000 and November 2002. Preoperative chest x-ray examination, pulmonary function tests, noninvasive cardiac testing, and blood work were performed routinely. Preoperative testing identified abnormalities on eight chest x-ray films (4%) and 29 electrocardiograms (15%), none of which required preoperative intervention. Spirometry was abnormal in 41 patients (21%); logistic regression identified preexisting asthma as predictive of obstructive physiology (odds ratio [OR] 3.3; 95% confidence interval [CI] 1.2 to 8.9), and body mass index as predictive of restrictive physiology (OR 1.1; 95% CI 1.01 to 1.2). Arterial blood gases identified only one case of severe hypoxemia requiring intervention. Mild hypoxemia was associated with increasing age (OR 14.5; 95% CI 1.8 to 114). Echocardiography demonstrated four abnormalities (2%); previous history of cardiac disease was the only risk factor (OR 14.5; 95% CI 1.8 to 114). Complete blood count did not identify 84% and 50% of the patients with iron (n=31) and vitamin B(12) (n=12) deficiencies, respectively. Age, body mass index, and history of asthma were associated with abnormal pulmonary function tests and previous cardiac disease with abnormal cardiac testing. These tests are not mandatory as a routine preoperative evaluation and can be used selectively on the basis of medical history.
Archana Ramaswamy; Rodrigo Gonzalez; C Daniel Smith
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  8     ISSN:  1091-255X     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-23     Completed Date:  2004-07-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  159-64; discussion 164-5     Citation Subset:  IM    
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
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MeSH Terms
Diagnostic Techniques and Procedures
Gastric Bypass*
Middle Aged
Obesity, Morbid / surgery*
Postoperative Complications / prevention & control*
Preoperative Care / methods*

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