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Abstract
INTRODUCTION. Existing classifications of various forms of obesity are poorly adapted to the practical goals of bariatric surgery from the standpoint of personalizing the choice of method and volume of intervention.The OBJECTIVE was develop new approaches to stratification of patients with morbid obesity based on cluster analysis; to evaluate of the effectiveness and safety of metabolic surgical interventions, depending on the belonging of patients to a particular bariatric cluster.METHODS AND MATERIALS. The study included 745 bariatric patients. To form clinical and demographic groups, a two-stage cluster analysis procedure was used using the SPSS 16.0 package with 11 categorical and 2 quantitative variables. The efficacy and safety of metabolic surgical interventions depending on the patients' belonging to a particular bariatric cluster was evaluated.RESULTS. As a result of cluster analysis in the general population of patients with morbid obesity, 3 unique clinical and demographic groups (clusters) of patients were identified, characterized by an initial set of similar indicators that differed from that in patients of other groups (clusters): the1st cluster: «premorbid obesity»; the 2nd cluster: «morbid obesity without metabolic syndrome and complications»; the 3rd cluster: «morbid obesity with metabolic syndrome and/ or complications». The best long-term results on the BAROS scale were generally observed in patients of the 1st cluster (87.8 % of excellent and good results compared to 66.7 % in patients of the 2nd clusters and 65.5 % in patients of the 3rd cluster, p<0.001). The total risk of serious complications in patients of the 3rd cluster was 2.4 times higher than in patients of the 1st cluster (P<0.05) and 1.9 times higher than in patients of the 2nd cluster (P>0.05).CONCLUSION. The procedure of clustering patients with obesity allows individualizing the indications for conducting and choosing bariatric interventions.
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