Abstract
Background: Currently no systematic Australian preoperative protocols exist for morbidly obese patients. We investigated theeffect of both clinical factors andpreoperative investigations on early adverse outcomes from this bariatric procedure. Methods: 266 consecutive patients were sampled retrospectively from a single centre. Pre-operative, operative and post-operative data was collected up to 30 days after surgery. Results: There were no Major Adverse Cardiovascular Events (MACE). Both age (ORper year of increased age 1.029; 95% CI: 1.000-1.058, p = 0.048) and BMI (OR for BMI: 1.066; 95% CI: 1.014-1.120, p = 0.012) were significantly associated withdesaturationpost-operatively.Diastolic dysfunction and left atrial enlargement appear to predict a worse outcome, including difficulty in intubation (“difficult airway”), the need for prolonged ICU admission, and the development of atrial arrhythmias. Sleep study (PSG) and carotid intimal scans did not effect post-operative outcome. Conclusions:Acombination of clinical factors (age, gender and BMI) and echocardiography (left atrial volume index, an indicator of diastolic dysfunction) appear to be the most useful tools in predicting perioperative risk within 30 days of sleeve gastrectomy surgery.
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