Cardiorespiratory Fitness and Short-term Complications After Bariatric Surgery


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Abstract

Background:Morbid obesity is associated with reduced functional capacity, multiple comorbidities, and higher overall mortality. The relationship between complications after bariatric surgery and preoperative cardiorespiratory fitness has not been previously studied.Methods:We evaluated cardiorespiratory fitness in 109 patients with morbid obesity prior to laparoscopic Roux-en-Y gastric bypass surgery. Charts were abstracted using a case report form by reviewers blinded to the cardiorespiratory evaluation results.Results:The mean age (± SD) was 46.0 ± 10.4 years, and 82 patients (75.2%) were female. The mean body mass index (BMI) was 48.7 ± 7.2 (range, 36.0 to 90.0 kg/m2). The composite complication rate, defined as death, unstable angina, myocardial infarction, venous thromboembolism, renal failure, or stroke, occurred in 6 of 37 patients (16.6%) and 2 of 72 patients (2.8%) with peak oxygen consumption (o2) levels < 15.8 mL/kg/min or > 15.8 mL/kg/min (lowest tertile), respectively (p = 0.02). Hospital lengths of stay and 30-day readmission rates were highest in the lowest tertile of peako2 (p = 0.005). There were no complications in those with BMI < 45 kg/m2 or peako2 ≥ 15.8 mL/kg/min. Multivariate analysis adjusting for age and gender found peako2 was a significant predictor of complications: odds ratio, 1.61 (per unit decrease); 95% confidence interval, 1.19 to 2.18 (p = 0.002).Conclusions:Reduced cardiorespiratory fitness levels were associated with increased, short-term complications after bariatric surgery. Cardiorespiratory fitness should be optimized prior to bariatric surgery to potentially reduce postoperative complications.

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