Preoperative Risk Factors of Gonzalez et al for Predicting a Prolonged Post-Operative ICU Admission Following a Roux-en-Y Gastric Bypass in a Morbidly Obese Patient
Gonzalez et al identified preoperative factors that are predictive of a morbidly obese patient of a prolonged intensive care unit (ICU) following a roux-en-Y gastric bypass procedure. This can identify a patient who may benefit from efforts to reduce risk prior to surgery or from selection of a procedure with less risk. The authors are from Emory University in Atlanta.
Parameters:
(1) body mass index (BMI)
(2) FEV1 as percent of predicted
(3) history of previous abdominal surgery
(4) ECG
Parameter
Finding
Points
body mass index (BMI)
<= 50 kg per square meter
0
> 50 kg per square meter
1
FEV1
>= 80% of predicted
0
< 80% of predicted
1
history of previous abdominal surgery
no
0
yes
1
ECG
normal
0
abnormal
1
where:
• The odds ratios are shown in Table 4 and range from 2.8 (for FEV1) to 6.8 (for abnormal ECG).
• The various reasons for the prolonged ICU admission are given in Table 1, page 1901.
number of risk factors present =
= SUM(points for the 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The risk of a prolonged ICU admission after surgery increases with the number of risk factors present.
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