Indications for Bariatric Surgery


BMI categories

BMI

Underweight

<18.5

Normal weight

18.5–24.9

Overweight

25–29.9

Obese

>30




Table 5.2
Absolute and relative contraindications to bariatric surgery [1, 2]




























Absolute

Relative

Contraindications to general anesthesia

Uncontrolled drug or alcohol dependence

Uncorrectable coagulopathy

Cirrhosis with portal hypertension

Pregnancy

End-stage lung disease
 
Active cancer
 
Unstable coronary artery disease
 
Heart failure



Table 5.3
Comorbidities associated with morbid obesity [2]











































Hypertension

Nephrotic syndrome

Coronary artery disease

Thrombophlebitis

Heart failure

Wound infections or dehiscence

Venous stasis ulcers

Sexual hormone dysfunction

Diabetes and insulin intolerance

Necrotizing subcutaneous infections

Degenerative osteoarthritis

Stress urinary incontinence

Cholelithiasis

Gastroesophageal reflux disease

Polycystic ovarian syndrome (PCOS)

Respiratory insufficiency of obesity (Pickwickian syndrome)

Pseudotumor cerebri

Obesity hypoventilation syndrome

Increased intra-abdominal pressure

Obesity sleep apnea syndrome

Nonalcoholic steatohepatitis

Venous disease

Pulmonary embolism
 


Studies have shown that morbid obesity poses higher perioperative risks. The Obesity Surgery Mortality Risk Score (OS-MRS) predicts the 90-day mortality risk after gastric bypass surgery. It looks at five preoperative variables (Table 5.4). The OS-MRS aids in risk stratification when preoperatively assessing whether bariatric surgery is a safe option for weight loss [1].


Table 5.4
The obesity surgery mortality risk score







Body mass index >50 kg/m2

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Jun 25, 2017 | Posted by in NURSING | Comments Off on Indications for Bariatric Surgery

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