Clinical and demographic characteristics in bariatric surgery patients in Medellin.
Article Sidebar
How to Cite
This work is licensed under a Creative Commons Attribution 3.0 Unported License.
Downloads
Societal impact
Main Article Content
Abstract
Objective: Severe obesity is a public health issue. Treatment includes nutritional plans, physical exercise, pharmacotherapy, and bariatric surgery. The objective of this study was to describe the clinical and demographic characteristics of patients who underwent bariatric surgery at a hospital in Medellín, Colombia between January and December of 2010.
Methods: Descriptive study which included 525 patients. Information from medical records was obtained and demographic, clinical, and surgical variables were considered. Variables of interest were described and exploratory analysis was conducted using MannWhitney U test and chi-square test; statistical significance was set at p<0.05.
Results: Women made up 80.6% of the population, where the median age was 39 years, interquartile range (31-49). The most frequent comorbidity was hypertension (56%), followed by dyslipidemia (44.8%). Patients who underwent bypass surgery had a median body mass index of 41.7 kg/m2, while patients who underwent sleeve gastrectomy had a median body mass index of 37.4 kg/m2, (p < 0.0001). In 36% of patients, at least one psychiatric disorder was present, the most frequent of which was major depression (13.5%). In patients who underwent bypass surgery, the most frequent 30-day postoperative complication was digestive bleeding in 1.7% of cases. No complications presented in gastric sleeve patients.
Conclusions: Of the patients, 56% presented at least one medical comorbidity, while 36% had at least one psychiatric comorbidity. This situation warrants a multidisciplinary therapeutic intervention. There was no post-operative mortality 30 days after surgery
Article Details
References
Ramírez A, Mesa P, Monsalve C, Aristizábal N. Enfoque diagnóstico y terapéutico del paciente con obesidad. Med U.P.B 2013; 32(2):151-170.
World Health Organization. Overweight and obesity, Global health observatory data [Internet]. Washington; 2014. Disponible en: http://www.who.int/gho/ncd/risk_factors/overweight/en/
ICBF, INS, Profamilia, Colombia. Ministerio de la Protección Social. Encuesta nacional de la situación nutricional en Colombia 2010 Ensin. Bogotá ICBF [Internet]. 2011; Disponible en: http://www.icbf.gov.co/portal/page/portal/PortalICBF/NormatividadC/ENSIN1/ENSIN2010/ LibroENSIN2010.pdf
Ruelaz AR. Psychiatric involvement in obesity treatment. 2009 [citado 25 de febrero de 2015]; Disponible en: http://focus.psychiatryonline.org/doi/abs/10.1176/foc.7.3.foc311
Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP, Pilkonis PA, Ringham RM, et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry 2007; 164(2):328–334.
DeMaria EJ. Bariatric surgery for morbid obesity. N Engl J Med 2007; 356(21):2176–2183.
Podnos YD, Jimenez JC, Wilson SE, Stevens CM, Nguyen NT. Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg 2003; 138(9):957–961.
Allen SR, Lawson L, Garcia V, Inge TH. Attitudes of bariatric surgeons concerning adolescent bariatric surgery (ABS). Obes Surg 2005; 15(8):1192–1195.
Consortium LA of BS (LABS), Flum DR, Belle SH, King WC, Wahed AS, Berk P, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med 2009; 361(5):445-454.
Wadden TA, Berkowitz RI, Womble LG, Sarwer DB, Phelan S, Cato RK, et al. Randomized trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med 2005; 353(20):2111–2120.
Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 357(8):741–752.
Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev [Internet]. 2009 [citado 25 de febrero de 2015];2. Disponible en: http://onlinelibrary.wiley.com/ doi/10.1002/14651858.CD003641.pub3/pdf/
Haslam D, Sattar N, Lean M. Obesity—time to wake up. Br Med J 2006; 333 (23):640-642.
Flum DR, Salem L, Elrod JAB, Dellinger EP, Cheadle A, Chan L. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA 2005; 294(15):1903–1908.
Livingston EH, Langert J. The impact of age and Medicare status on bariatric surgical outcomes. Arch Surg 2006; 141(11):1115–1120.
Hofsø D, Nordstrand N, Johnson LK, Karlsen T-I, Hager H, Jenssen T, et al. Obesity-related cardiovascular risk factors after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention. Eur J Endocrinol 2010; 163(5):735–745.
Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med 2007; 357(8):753–761.
Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292(14):1724–1737.
Rubino F, Nathan DM, Eckel RH, Schauer PR, Alberti KGMM, Zimmet PZ, et al. Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. Diabetes Care 2016; 39(6):861-877.
Nieman LK, Biller BM, Findling JW, Newell-Price J, Savage MO, Stewart PM, et al. The diagnosis of Cushing’s syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2008; 93(5):1526–1540.
Buchwald H. Consensus conference statement: bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. Surg Obes Relat Dis 2005; 1(3):371–381.
Regan JP, Inabnet WB, Gagner M, Pomp A. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 2003; 13(6):861–864.
Cottam D, Qureshi FG, Mattar SG, Sharma S, Holover S, Bonanomi G, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc Interv Tech 2006; 20(6):859–863.
Sarwer DB, Cohn NI, Gibbons LM, Magee L, Crerand CE, Raper SE, et al. Psychiatric diagnoses and psychiatric treatment among bariatric surgery candidates. Obes Surg 2004; 14(9):1148–1156.
Marcus MD, Kalarchian MA, Courcoulas AP. Psychiatric evaluation and follow-up of bariatric surgery patients. 2009 [citado 25 de febrero de 2015]; Disponible en: http://ajp.psychiatryonline. org/doi/full/10.1176/appi.ajp.2008.08091327
Mühlhans B, Horbach T, de Zwaan M. Psychiatric disorders in bariatric surgery candidates: a review of the literature and results of a German prebariatric surgery sample. Gen Hosp Psychiatry 2009; 31(5):414–421.
Ministerio de la Protección Social. Estudio nacional de consumo de sustancias psicoactivas en Colombia-2008. Bogotá: Dirección Nacional de Estupefacientes; 2009.
Buffington CK, Daley DL, Warthen M, Marema RT. Changes in alcohol sensitivity and effects with gastric bypass. Surg Obes Relat Dis 2006; 2(3):317–318.
Hagedorn JC, Encarnacion B, Brat GA, Morton JM. Does gastric bypass alter alcohol metabolism? Surg Obes Relat Dis 2007; 3(5):543–548.
Schauer PR, Ashton K. Addictions after bariatric surgery [portal en Internet]. Irvine, California: Obesity Help; 2007 [actualizado Ene 2007; citado 4 feb 2010]. Disponible en: www.obesityhelp. com/forums/rny/cmsID,11273/mode,content.