Evaluation of risk factors in superobese patients submitted to conventional Fobi-Capella surgery

BACKGROUND: Obesity is one of the world’s greatest health problems. The Roux-en-Y gastric bypass is the gold standard treatment for severe obesity. Surgery in obese patients has an acceptable level of morbidity and mortality. The superobese patient, a subcategory of severe obese patients with a high surgical risk has not yet been analyzed as a group. METHODS: A retrospective and prospective cohort study was conducted enrolling 135 patients submitted to Roux-en-Y gastric bypass for treatment of severe obesity at the " Hospital das Clínicas" , Federal University of Pernambuco, Recife, PE, Brazil, between November 1997 and September 2003. The independent variables were possible risk factors of adverse outcomes: age, gender, weight, body mass index, diabetes, hypertension, hypercholesterolemia, sleep apnea, cardiopathy/coronariopathy, pneumopathy or any other co-morbidity. The dependent variables were major complications, minor complications and death. RESULTS: Diabetes (RR = 1.6 and CI = 1.02-2.40) and sleep apnea (RR = 1.8 and CI = 1.18-2.64) were associated to minor complications. Cardiopathy/coronariopathy were associated with major complications (RR = 5.42 and CI = 1.22-2.40) and death (RR = 16.25 and CI = 3.00-87.95). BMI >55 kg/m² was associated with minor complications (RR = 1.58 and CI = 1.04-2.40), major complications (RR = 3.17 and CI = 1.03-9.80) and death (P = 0.007). After logistic regression, the body mass index >55 kg/m² remained as a strong risk factor of death (OR = 3.6 and CI = 1.05-12.32). CONCLUSIONS: The body mass index >55 kg/m² was the main risk factor for severe complications and death. Other risk factors affecting the outcome were diabetes, obstructive sleep apnea and cardiopathy/coronariopathy.

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Association between obesity and venous thromboembolism

Medicine and Pharmacy Reports ◽

10.15386/mpr-1372 ◽

2020 ◽

Author(s):

Cristina Hotoleanu

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Venous Thromboembolism ◽

Body Mass ◽

Logistic Regression Analysis ◽

The Body ◽

Increased Risk

Background and aims. Obesity is associated with numerous pathological conditions, including venous thromboembolism (VTE). VTE is a multifactorial disease; more than half of the hospitalized patients are at risk for VTE. We aimed to assess the risk of VTE associated with obesity, taking into account the class of obesity (according to the body mass index), gender, age and the intervention of other acquired risk factors. Method. A case-control study including 732 patients was designed. Collected data included: age, gender, body mass index, pregnancy/ postpartum state, use of hormonal therapy, personal and family history of VTE, smoking, prolonged immobilization and the presence of comorbidities- acquired risk factors for VTE. The risk of VTE was expressed as odds ratio (OR) with 95% confidence interval. Multiple logistic regression analysis was used to detect the independent risk factors. P value < 0.05 was considered significant statistic. Results. Obesity was associated with a 6.2- fold increased risk for VTE. The risk of VTE associated with obesity was highest in patients aged >50 years and in cases included in classes II and III of obesity. The interaction between obesity and another acquired risk factor has almost doubled the risk of VTE. Multivariate logistic regression analysis showed obesity as an independent risk factor for VTE for both female and male patients. Conclusion. Obesity is an independent and moderate risk factor for VTE. The risk increases with body mass index, age and the presence of other acquired risk factors.

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A Comparative Analysis on Body Composition, Risk Factors of Metabolic Disease, and Arteriosclerosis According to the Body Mass Index of Female College Students

Korean Journal of Sports Science ◽

10.35159/kjss.2018.12.27.6.939 ◽

2018 ◽

Vol 27 (6) ◽

pp. 939-947

Author(s):

Chul-Soon Choi

Keyword(s):

Risk Factors ◽

College Students ◽

Metabolic Disease ◽

Body Mass Index ◽

Body Composition ◽

Comparative Analysis ◽

Body Mass ◽

The Body ◽

Female College Students ◽

Female College

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Body Mass Index, Multi-Morbidity, and COVID-19 Risk Factors as Predictors of Severe COVID-19 Outcomes

Journal of Primary Care & Community Health ◽

10.1177/21501327211018559 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110185

Author(s):

Sanjeev Nanda ◽

Audry S. Chacin Suarez ◽

Loren Toussaint ◽

Ann Vincent ◽

Karen M. Fischer ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Hospital Admission ◽

Body Mass ◽

Risk Score ◽

The Body ◽

Risk Scores ◽

Nasopharyngeal Swab ◽

Morbidity Score ◽

The Impact

Purpose The purpose of the present study was to investigate body mass index, multi-morbidity, and COVID-19 Risk Score as predictors of severe COVID-19 outcomes. Patients Patients from this study are from a well-characterized patient cohort collected at Mayo Clinic between January 1, 2020 and May 23, 2020; with confirmed COVID-19 diagnosis defined as a positive result on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assays from nasopharyngeal swab specimens. Measures Demographic and clinical data were extracted from the electronic medical record. The data included: date of birth, gender, ethnicity, race, marital status, medications (active COVID-19 agents), weight and height (from which the Body Mass Index (BMI) was calculated, history of smoking, and comorbid conditions to calculate the Charlson Comorbidity Index (CCI) and the U.S Department of Health and Human Services (DHHS) multi-morbidity score. An additional COVID-19 Risk Score was also included. Outcomes included hospital admission, ICU admission, and death. Results Cox proportional hazards models were used to determine the impact on mortality or hospital admission. Age, sex, and race (white/Latino, white/non-Latino, other, did not disclose) were adjusted for in the model. Patients with higher COVID-19 Risk Scores had a significantly higher likelihood of being at least admitted to the hospital (HR = 1.80; 95% CI = 1.30, 2.50; P < .001), or experiencing death or inpatient admission (includes ICU admissions) (HR = 1.20; 95% CI = 1.02, 1.42; P = .028). Age was the only statistically significant demographic predictor, but obesity was not a significant predictor of any of the outcomes. Conclusion Age and COVID-19 Risk Scores were significant predictors of severe COVID-19 outcomes. Further work should examine the properties of the COVID-19 Risk Factors Scale.

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Identification of Endothelial Proteins in Plasma Associated With Cardiovascular Risk Factors

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvbaha.121.316779 ◽

2021 ◽

Author(s):

Maria J. Iglesias ◽

Larissa D. Kruse ◽

Laura Sanchez-Rivera ◽

Linnea Enge ◽

Philip Dusart ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Risk Factor ◽

Total Cholesterol ◽

Body Mass ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factor ◽

Venous Disease

Objective: Endothelial cell (EC) dysfunction is a well-established response to cardiovascular disease risk factors, such as smoking and obesity. Risk factor exposure can modify EC signaling and behavior, leading to arterial and venous disease development. Here, we aimed to identify biomarker panels for the assessment of EC dysfunction, which could be useful for risk stratification or to monitor treatment response. Approach and Results: We used affinity proteomics to identify EC proteins circulating in plasma that were associated with cardiovascular disease risk factor exposure. Two hundred sixteen proteins, which we previously predicted to be EC-enriched across vascular beds, were measured in plasma samples (n=1005) from the population-based SCAPIS (Swedish Cardiopulmonary Bioimage Study) pilot. Thirty-eight of these proteins were associated with body mass index, total cholesterol, low-density lipoprotein, smoking, hypertension, or diabetes. Sex-specific analysis revealed that associations predominantly observed in female- or male-only samples were most frequently with the risk factors body mass index, or total cholesterol and smoking, respectively. We show a relationship between individual cardiovascular disease risk, calculated with the Framingham risk score, and the corresponding biomarker profiles. Conclusions: EC proteins in plasma could reflect vascular health status.

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19 IMPACT OF ADENOTONSILLECTOMY ON THE BODY MASS INDEX OF CHILDREN WITH OBSTRUCTIVE SLEEP APNEA

Journal of Investigative Medicine ◽

10.2310/6650.2005.00005.18 ◽

2005 ◽

Vol 53 (1) ◽

pp. S81.2-S81

Author(s):

R. B. Mitchell ◽

C. Kerwin ◽

S. A. Stoerner ◽

B. Skipper

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Body Mass ◽

The Body ◽

Obstructive Sleep

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Frequency of Genital Infections According to Body Mass Index in Dapagliflozin-treated Patients with Type 2 Diabetes Mellitus

Experimental and Clinical Endocrinology & Diabetes Reports ◽

10.1055/s-0043-101823 ◽

2017 ◽

Vol 04 (01) ◽

pp. e1-e4

Author(s):

Gottfried Rudofsky ◽

Tanja Haenni ◽

John Xu ◽

Eva Johnsson

Keyword(s):

Type 2 Diabetes ◽

Body Mass Index ◽

Body Mass ◽

The Body ◽

Baseline Body Mass Index ◽

Obese Patients ◽

Genital Infections ◽

Increased Risk ◽

Three Body

Abstract Genital infections are associated with sodium glucose co-transporter 2 inhibitors such as dapagliflozin. Since patients with Type 2 diabetes are at increased risk of genital infections, and obesity is a risk factor for infections, obese patients with Type 2 diabetes could be more susceptible to genital infections when treated with sodium glucose co-transporter 2 inhibitors. This pooled dataset assessed the frequency of genital infections according to baseline body mass index in patients treated with dapagliflozin 10 mg. Data were pooled from 13 studies of up to 24 weeks’ duration (dapagliflozin N=2 360; placebo N=2 295). Frequency of genital infections was compared between three body mass index subgroups (<30, ≥30−< 35 and ≥35 kg/m2). Genital infections were reported in 130 (5.5%) patients receiving dapagliflozin and 14 (0.6%) patients receiving placebo; none of which were serious. Genital infections were more common in women (84/130 [64.6%]) than in men (46/130 [35.4%]) treated with dapagliflozin. In the body mass index < 30, ≥ 30−< 35 and ≥ 35 kg/m2 dapagliflozin-treated subgroups, 38/882 (4.3%), 47/796 (5.9%) and 45/682 (6.6%) patients presented with genital infections, respectively. Although the frequency was low overall and relatively similar between subgroups, there was a trend towards an increase in genital infections in patients with a higher body mass index. This trend is unlikely to be clinically relevant or to affect suitability of dapagliflozin as a treatment option for obese patients with Type 2 diabetes, but rather should influence advice and counselling of overweight patients on prevention and treatment of genital infections.

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Resolution of Symptomatic Obstructive Sleep Apnea Not Impacted by Preoperative Body Mass Index, Choice of Operation Between Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Surgery, or Severity

Obesity Surgery ◽

10.1007/s11695-017-3042-6 ◽

2017 ◽

Vol 28 (5) ◽

pp. 1402-1407 ◽

Cited By ~ 4

Author(s):

Kamyar Hariri ◽

Subhash U. Kini ◽

Daniel M. Herron ◽

Gustavo Fernandez-Ranvier

Keyword(s):

Body Mass Index ◽

Obstructive Sleep Apnea ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Sleep Apnea ◽

Body Mass ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Preoperative Body Mass Index ◽

Obstructive Sleep

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One-Stage vs Two-Stage Laparoscopic Roux-en-Y Gastric Bypass in Obese Patients with Body Mass Index >55 Kg/m2; 5-YEAR FOLLOW UP

Obesity Surgery ◽

10.1007/s11695-016-2411-x ◽

2016 ◽

Vol 27 (4) ◽

pp. 955-960 ◽

Cited By ~ 2

Author(s):

María Díaz-Tobarra ◽

Norberto Cassinello Fernández ◽

Pablo Jordá Gómez ◽

Mohammad Nebih Nofal ◽

Raquel Alfonso Ballester ◽

...

Keyword(s):

Body Mass Index ◽

Gastric Bypass ◽

Body Mass ◽

Obese Patients ◽

Two Stage ◽

One Stage

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The Impact of the Body Mass Index on Outcome After Subarachnoid Hemorrhage

Neurosurgery ◽

10.1227/01.neu.0000430322.17000.82 ◽

2013 ◽

Vol 73 (2) ◽

pp. 201-208 ◽

Cited By ~ 22

Author(s):

Johannes Platz ◽

Erdem Güresir ◽

Patrick Schuss ◽

Jürgen Konczalla ◽

Volker Seifert ◽

...

Keyword(s):

Body Mass Index ◽

Subarachnoid Hemorrhage ◽

Body Mass ◽

Glasgow Outcome Scale ◽

The Body ◽

Favorable Outcome ◽

World Federation ◽

Obese Patients ◽

Aneurysm Size ◽

The Impact

Abstract BACKGROUND: Obesity is a risk factor for cardiovascular disease and associated with a poor outcome, especially for intensive care patients. However, recent studies have described favorable outcomes of obese patients after stroke, a phenomenon called the “obesity paradox.” OBJECTIVE: To assess the impact of the body mass index (BMI) on outcome after subarachnoid hemorrhage (SAH). METHODS: We analyzed the data for 741 SAH patients. A BMI greater than 25 kg/m2 was considered overweight and greater than 30 kg/m2 obese. The outcome according to the Glasgow Outcome Scale at discharge and after 6 months was assessed using logistic regression analysis. RESULTS: According to the BMI, 268 patients (36.2%) were overweight and 113 (15.2%) were obese. A favorable outcome (Glasgow Outcome Scale score >3) was achieved in 53.0% of overweight patients. In contrast, 61.4% of the 360 patients with a normal BMI had a favorable outcome (P = .021). However, in the multivariate analysis, only age (odds ratio [OR]: 1.051, 95% confidence interval [CI]: 1.04-1.07, P < .001), World Federation of Neurological Surgeons grade (OR: 2.095, 95% CI: 1.87-2.35, P < .001), occurrence of vasospasm (OR: 2.90, 95% CI: 1.94-4.34, P < .001), and aneurysm size larger than 12 mm (OR: 2.215, 95% CI: 1.20-4.10, P = .011) were independent predictors of outcome after 6 months. Of the 321 poor grade patients (World Federation of Neurological Surgeons score >3), 171 (53.3%) were overweight. Of these, 21.6% attained a favorable outcome compared with 35.3% of normal-weight patients (P = .006). CONCLUSION: Although many physicians anticipate a worse outcome for obese patients, in our study, the BMI was not an independent predictor of outcome. Based on the BMI, obesity seems to be negligible for outcome after SAH compared with the impact of SAH itself, the patient's age, occurrence of vasospasm, or aneurysm size.

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