Morbidly obese subjects with airflow obstruction who underwent laparoscopic bariatric surgery appear to have the greatest risk to develop complications. In a retrospective cohort study, we identified a waist circumference ? 120 cm, smoking history ?5PY and history of obstructive lung disease as statistically significant predictors of airflow obstruction. The resulting algorithm, aimed to identify subjects with airflow obstruction before bariatric surgery, was validated in a prospective study. The algorithm was found to be effective in identifying patients with low risk of airflow obstruction (negative predictive value 94.7%). Airflow obstruction, however, was not associated with post-operative complications as we expected. In contrast, inspiratory capacity and the Epworth Sleepiness scale were more promising predictors for post-operative complications in subjects undergoing bariatric surgery.
Adult Algorithms