Patient selection: bariatric surgery
Parameters:
(1) gender
(2) age
(3) body mass index (BMI)
(4) ASA class
(5) diabetes mellitus
(6) corticosteroid therapy
(7) operation time
(8) type of procedure
(9) complication
(10) dyspnea
|
Parameter
|
Finding
|
Points
|
|
gender
|
female
|
0
|
|
|
male
|
1
|
|
age
|
> 70 years of age
|
1
|
|
|
<= 70 years
|
0
|
|
body mass index
|
>= 50 kg per square meter
|
1
|
|
|
< 50 kg per square meter
|
|
|
ASA class
|
I or II
|
0
|
|
|
III, IV or V
|
1
|
|
diabetes mellitus
|
insulin dependent
|
1
|
|
|
not insulin dependent
|
0
|
|
|
not diabetic
|
0
|
|
corticosteroid therapy
|
no
|
0
|
|
|
yes
|
1
|
|
operation time
|
prolonged
|
1
|
|
|
not prolonged
|
0
|
|
type of procedure
|
lap band
|
0
|
|
|
not lap band
|
1
|
|
complication
|
major
|
1
|
|
|
minor
|
0
|
|
|
none
|
0
|
|
dyspnea
|
at rest
|
1
|
|
|
other
|
0
|
where:
• An open bypass was associated with both complications and readmission.
• Major complications: pulmonary embolism, COPD exacerbation, reintubation, surgical site infection, urinary tract infection, pneumonia, congestive heart failure, myocardial infarction, acute kidney injury, stroke, deep vein thrombosis, bleeding requiring transfusion, sepsis/septic shock.
• Bariatric surgery would probably not be done on a person with ASA class V.
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: 0
• maximums core: 10
• The higher the score the greater the risk of unplanned readmission.
