Bariatric surgery outcomes in oxygen-dependent patients: analysis of the MBSAQIP database.

Bariatric surgery outcomes in oxygen-dependent patients: analysis of the MBSAQIP database. Surg Obes Relat Dis. 2019 Jul 04;: Authors: Afraz S, Dang JT, Modasi A, Switzer N, Birch DW, Karmali S Abstract BACKGROUND: The number of bariatric procedures performed on complex, oxygen-dependent patients has increased. These patients often have other medical co-morbidities that can be improved after bariatric surgery; however, questions remain regarding their perioperative risk. OBJECTIVE: To assess the safety of bariatric surgery among oxygen-dependent patients, and to compare outcomes in this patient group after laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy. SETTING: University and private hospitals enrolled in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry. METHODS: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data from 2015 to 2017 was analyzed. A multivariable regression analysis was performed looking at 30-day serious complications for oxygen-dependent patients, with a secondary propensity-matched analysis performed comparing patients undergoing laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass. RESULTS: In total, 430,396 patients were analyzed, 3034 (0.7%) of whom were oxygen dependent. The absolute 30-day complication rate among oxygen-dependent patients was more than twice as high (8.24% vers...
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - Category: Surgery Authors: Tags: Surg Obes Relat Dis Source Type: research

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Publication date: Available online 13 November 2019Source: Clinica Chimica ActaAuthor(s): Julia Oto, Álvaro Fernández-Pardo, Manuel Miralles, Emma Plana, Francisco España, Silvia Navarro, Pilar MedinaAbstractActivated protein C (APC) acts as an “on demand” anticoagulant, reducing thrombin formation. Reduced plasma levels of APC or protein C (PC) are associated with an increased risk of venous thromboembolism. APC also displays cytoprotective functions and its therapeutic use has been evaluated in severe sepsis and is under evaluation in several diseases with an important inflammatory compon...
Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research
Editor's Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the November 05, 2019 issue
Source: JAMA: This Week's Audio Commentary - Category: General Medicine Authors: Source Type: podcasts
ConclusionsWith the application of a dual model, there appears to be no significant difference in mortality of obese patients with pneumonia compared to normal BMI patients with pneumonia.
Source: Obesity Research and Clinical Practice - Category: Eating Disorders & Weight Management Source Type: research
Patients undergoing bariatric surgery have been shown to be at increased risk of pneumonia compared to the general population. Although postoperative pneumonia is uncommon, it represents a serious potential morbidity, but to our knowledge there are few papers looking at specific factors that increase this population ’s likelihood of postoperative pneumonia. Our aim is to identify risk factors for postoperative pneumonia in patients having weight loss surgery.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Discussion Pulmonary embolism (PE) is potentially life-threatening but fortunately rare event especially in the pediatric population. It was first described in children in 1861. PE is likely underreported because of minimal or non-specific clinical symptoms. The incidence is estimated at 0.05-4.2% with the 4.2% based on autopsy reports. It is probably also increasing as more central venous catheters (CVC) are used, and more children are surviving previously poor prognostic diseases. There is a bimodal distribution with cases
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
AbstractIntroductionLaparoscopic sleeve gastrectomy (LSG) is a widely accepted stand-alone bariatric operation. Data on adolescent patients undergoing LSG are limited. The aim of this study was to demonstrate that LSG is safe and effective for patients strictly under 18  years old with severe obesity.MethodsProspectively collected data from consecutive patients undergoing LSG were retrospectively analyzed. Patients with more than 1-year follow-up were included in the analysis for weight loss and comorbidity evaluation. Quality of life (QoL) was evaluated using the Short-Form 36 questionnaire.ResultsEighty-four patient...
Source: Obesity Surgery - Category: Surgery Source Type: research
Obstructive Sleep Apnea (OSA) is highly prevalent among patients seeking bariatric surgery, and the gold standard treatment is continuous positive airway pressure (CPAP) (1). However, CPAP use is variable, with studies in general, non-bariatric populations reporting that 46-83% of individuals stop using their CPAP devices after the initial trial period (2). CPAP non-adherence is particularly problematic in bariatric surgery patients; in the immediate post-operative phase, CPAP non-adherence is associated with significant complications, including pneumonia and transfer to ICU (3).
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
We describe the case of a 13-year-old patient with severe obesity (at presentation body mass> 120 kg, BMI> 40 kg/m2), who developed HHS (glycaemia 647 mg/dl, pH 7.18, pCO2 96.5 mmHg, BE - 5.0 mmol/l, HCO3 35.2 mmol/l; Na 167 mmol/l, plasma osmolarity 370 mOsm/kg) in the course of pneumonia and newly diagnosed type 2 diabetes (HbA1c 15.5%, C-peptide 2.63 ng/ml). In the follow-up, due to the hypoglycaemia, insulin was discontinued, metformin was administered at a dose of 2 g/day, with a further reduction to 500 mg/day, together with physical rehabilitation and a low-calorie diet. Weight reducti...
Source: Pediatric Endocrinology, Diabetes, and Metabolism - Category: Endocrinology Authors: Tags: Pediatr Endocrinol Diabetes Metab Source Type: research
ConclusionsThis study underlined a significant correlation between OAGB-MGB and reflux/starting general anaesthesia in post-bariatric patients. In our experience we believe that it can be useful enlarge the pre-operatory fasting period and positioning a nasogastric tube during anaesthesia induction that can be performed moreover, in anti-Trendelenburg position, in order to prevent pulmonary aspiration.
Source: Obesity Surgery - Category: Surgery Source Type: research
OBJECTIVE: The present study aimed to investigate the relationship between obesity and mortality in patients with community-acquired pneumonia (CAP) in China. METHODS: In total, 909 patients with CAP were recruited for this study from January 2010 to June 2015. All patients were selected and divided into 4 groups according to their body mass index (BMI) values. All patients ’ clinical information was recorded. The associations among mortality; BMI; the 30-day, 6-month and 1-year survival rates for different BMI classes; the etiology of pneumonia in each BMI group; and the risk factors for 1-year mortality in CAP pati...
Source: Clinics - Category: General Medicine Source Type: research
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