Preoperative factors predictive of complicated postoperative management after Roux-en-Y gastric bypass for morbid obesity

Introduction: This study was undertaken to determine preoperative predictive factors of complicated postoperative management after Roux-en-Y gastric bypass (RYGB) for morbid obesity.Methods: Between January 1999 and January 2002, 158 patients who underwent a RYGB received a standardized preoperative evaluation and data were collected prospectively. Complicated postoperative management was defined as patients requiring postoperative ICU admission for 48 h, or those needing transfer from the floor to the ICU. Patients with complicated management were compared with those in whom ICU admission was not necessary.Results: Twenty-three patients (14.5%) required prolonged ICU admission (mean stay of 6.3 ± 1.7 days). After multivariate analysis, body mass index (BMI) >50 kg/m², forced expiratory volume (FEV₁) <80% predicted, previous abdominal surgeries, and abnormal EKG were found to be independently associated with an increased likelihood of complicated postoperative care.Conclusion: BMI >50 kg/m², FEV₁ <80% predicted, previous abdominal surgeries, and abnormal EKG increase the likelihood of complicated postoperative management after RYGB for morbid obesity.Presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) Los Angeles, CA, USA, March 15, 2003.