Proposal of a score to detect the need for postoperative intensive care unit admission after bariatric surgery
Nofal, W., Amer, A., Mansour, W. (2017). Proposal of a score to detect the need for postoperative intensive care unit admission after bariatric surgery. EKB Journal Management System, 33(4), 351-355. doi: 10.1016/j.egja.2017.08.003
Walid H. Nofal; Akram M. Amer; Walid A. Mansour. "Proposal of a score to detect the need for postoperative intensive care unit admission after bariatric surgery". EKB Journal Management System, 33, 4, 2017, 351-355. doi: 10.1016/j.egja.2017.08.003
Nofal, W., Amer, A., Mansour, W. (2017). 'Proposal of a score to detect the need for postoperative intensive care unit admission after bariatric surgery', EKB Journal Management System, 33(4), pp. 351-355. doi: 10.1016/j.egja.2017.08.003
Nofal, W., Amer, A., Mansour, W. Proposal of a score to detect the need for postoperative intensive care unit admission after bariatric surgery. EKB Journal Management System, 2017; 33(4): 351-355. doi: 10.1016/j.egja.2017.08.003

Proposal of a score to detect the need for postoperative intensive care unit admission after bariatric surgery

Egyptian Journal of Anaesthesia
Volume 33, Issue 4, October 2017, Page 351-355  XML PDF (563.15 K)
DOI: 10.1016/j.egja.2017.08.003
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Authors
Walid H. Nofal; Akram M. Amer; Walid A. Mansour
Abstract
Background
We developed a multi-dimensional score which may help in predicting those patients, undergoing bariatric surgery, who may be in need for postoperative ICU admission and which may also help in avoiding unnecessary admission to the critical care units after bariatric surgery.
Methods
We collected the data of 111patients who underwent either laparoscopic gastric sleeve or bypass and studied the association between some risk factors related to obesity and their postoperative ICU admission. Those factors found to be statistically significant are included in the final score. The cutoff value of our scoring system is determined by running a Receiver Operating Curve (ROC) analysis.
Results
Forty patients (36%) were admitted to the ICU postoperatively. Our final score includes 7 independent variables; 6 found to be significantly related to post-bariatric surgery ICU admission; these are age, gender, BMI, ASA, obstructive sleep apnea and spirometry results, and the seventh is the history of venous thrombo-embolism. According to the ROC curve analysis, we set the score value of 10 as our cut-off value for the need of postoperative ICU admission. The score median value is 9. Males’ odds to be admitted to the ICU after bariatric surgery are 11.9 times higher than females. Also, those with BMI above 50 kg m have odds of 29.8 times higher than those below 50 kg m.
Conclusions
We propose a scoring system for risk stratification, in which some of the well-known predictor risk factors are included in a simple way to help identify those high-risk patients undergoing bariatric surgery.
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