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Higher Edmonton Obesity Staging System scores are associated with complications following laparoscopic Roux-en-Y gastric bypass

  • 2019 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

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).

Methods

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.

Results

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/m2. 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).

Conclusion

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.

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Funding

This study did not require nor did it receive any funding.

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Authors and Affiliations

  1. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

    Samuel L. Skulsky & Adrian Battiston

  2. Department of Surgery, University of Alberta, Edmonton, AB, Canada

    Jerry T. Dang, Noah J. Switzer, Daniel W. Birch & Shahzeer Karmali

  3. Department of Medicine, University of Alberta, Edmonton, AB, Canada

    Arya M. Sharma

Authors
  1. Samuel L. Skulsky
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  2. Jerry T. Dang
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  4. Noah J. Switzer
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  6. Arya M. Sharma
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Correspondence to Jerry T. Dang.

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Disclosures

Dr. Arya M Sharma reports personal fees from Novo Nordisk and Valeant, outside the submitted work. Drs. Jerry T. Dang, Noah J. Switzer, Daniel W. Birch, Shahzeer Karmali, and Mr. Samuel L. Skulsky and Mr. Adrian Battiston have no conflicts of interest or financial ties to disclose.

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Skulsky, S.L., Dang, J.T., Battiston, A. et al. Higher Edmonton Obesity Staging System scores are associated with complications following laparoscopic Roux-en-Y gastric bypass. Surg Endosc 34, 3102–3109 (2020). https://doi.org/10.1007/s00464-019-07067-4

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  • DOI: https://doi.org/10.1007/s00464-019-07067-4

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