Predicting surgical risk in morbidly obese patients

The OBJECTIVE was to improve the results of surgical treatment of morbid obesity by reducing the frequency of postoperative complications.

METHODS AND MATERIALS. The research is based on the studying the results of surgical treatment of 149 morbidly obese patients. The patients were divided into retrospective (49 patients) and prospective (100 patients) groups.

RESULTS. Among the patients of the retrospective group (n=49), a statistical analysis of the effectiveness of using various scales and indices for predicting the risk of complications of bariatric interventions was carried out. The analysis revealed the low efficiency of currently available tools for predicting the risk of complications in this category of patients. The totality of prognostically important factors and their ratings were integrated into the original «Individual Risk Assessment Scale for Bariatric Surgery». The results obtained during the study made it possible to integrate the developed tactics of preoperative examination and preparation for surgical intervention in morbidly obese patients into a practical algorithm. Application of the developed tools for predicting the risk of complications in bariatric surgeries allowed to reduce the complication rate from 12.2 % to 2.0 %, and the mortality rate from 2.0 % to 0 %.

CONCLUSION. The use of the developed tools for predicting the risk of complications of bariatric surgery improves results by reducing the frequency of complications in the early postoperative period, which in turn expands the capabilities of using metabolic surgery for patients at high surgical risk, including those over 60 years of old.

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