Featured Research

from universities, journals, and other organizations

Severe Obesity Increases Risks Of Health Problems During Surgery

Date:
June 22, 2009
Source:
American Heart Association
Summary:
Severe obesity can pose special challenges, including cardiac risks, in patients undergoing surgery; healthcare providers must carefully evaluate those risks and not underestimate them. The risk of a cardiac event before, during or after surgery in obese patients is related to the type and severity of their heart's condition, as well as other health conditions and the type of surgery they are having.

Healthcare providers must carefully consider the unique risk factors related to severe obesity in patients undergoing all types of surgery, according to an American Heart Association scientific advisory published in Circulation: Journal of the American Heart Association.

Heart problems in particular are often underestimated during a physical examination in the severely obese patient, according to the advisory.

“A severely obese patient can be technically difficult to evaluate prior to surgery,” said Paul Poirier, M.D., Ph.D., lead author of the advisory and associate professor at Université Laval Institut universitaire de cardiologie et de pneumologie Hôpital Laval in Québec, Canada. “For example, severely obese people might feel chest tightness that could be a symptom of their obesity or of an underlying cardiac problem. Doctors need to carefully evaluate severely obese patients before they have surgery.”

Severe obesity describes people with a body mass index (BMI) of 40 or higher. This type of obesity, affecting 3 percent to 4 percent of the population, is associated with health problems that may lead to disability and death.

“In the obese population, the severely obese make up the fastest growing segment,” Poirier said.

The advisory provides cardiologists, surgeons, anesthesiologists and other healthcare providers pre-operative evaluation recommendations, along with information on managing and caring for obese patients during and after any surgery, including such procedures as knee replacement, abdominal surgery or a heart operation.

Conditions associated with obesity that could increase heart risks in surgery include:

  • Heart failure
  • Atherosclerosis (thickened or narrowed arteries)
  • High blood pressure
  • Heart rhythm disorders
  • History of blood clots (especially pulmonary embolism)
  • Poor exercise capacity
  • Pulmonary hypertension related to sleep apnea

The clinician should consider age, gender, cardiorespiratory fitness, electrolyte disorders and heart failure as independent predictors for death or complications from surgery, according to the advisory.

The advisory offers a proposed scoring tool to assess risk for patients preparing to have weight-loss surgery and Poirier says additional research is also needed to develop obesity risk scores to identify patients at increased risk specific to other surgeries.

Healthcare providers should be aware that severely obese patients are more likely to stay on a ventilator longer and have a longer hospital stay than patients who are not severely obese, the statement’s authors said.

It’s reasonable to do an electrocardiogram and a chest X-ray in this population, and other non-invasive testing, including exercise testing, may also be advisable, according to the advisory.

However, “some surgeons are under the impression that severely obese patients are more likely to die in surgery than people who are not obese, and won’t operate on them as a result,” Poirier said. “This is not true. Severely obese patients are at increased risk for pulmonary embolism, wound infection and other conditions. But they are not more likely than their lower-weight counterparts to die as a result of surgery.”

Severely obese people should ask their surgeons whether a particular surgery is safe for a patient their size.

“Since recovery can be a problem for these patients, we recommend that they take steps to be as healthy as possible before going into surgery,” Poirier said. “For example, the person with diabetes should get his or her blood sugar under control.”

Co-authors are Martin A. Alpert, M.D.; Lee A Fleisher, M.D.; Paul D. Thompson, M.D.; Harvey Sugerman, M.D.; Lora E. Burke, Ph.D., M.P.H.; Kimberly F. Stitzel, M.S., R.D.; Picard Marceau, M.D.; and Barry Franklin, Ph.D. Author disclosures are on the manuscript.


Story Source:

The above story is based on materials provided by American Heart Association. Note: Materials may be edited for content and length.


Cite This Page:

American Heart Association. "Severe Obesity Increases Risks Of Health Problems During Surgery." ScienceDaily. ScienceDaily, 22 June 2009. <www.sciencedaily.com/releases/2009/06/090615161659.htm>.
American Heart Association. (2009, June 22). Severe Obesity Increases Risks Of Health Problems During Surgery. ScienceDaily. Retrieved July 22, 2014 from www.sciencedaily.com/releases/2009/06/090615161659.htm
American Heart Association. "Severe Obesity Increases Risks Of Health Problems During Surgery." ScienceDaily. www.sciencedaily.com/releases/2009/06/090615161659.htm (accessed July 22, 2014).

Share This




More Health & Medicine News

Tuesday, July 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) — Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com
Why Do People Believe We Only Use 10 Percent Of Our Brains?

Why Do People Believe We Only Use 10 Percent Of Our Brains?

Newsy (July 22, 2014) — The new sci-fi thriller "Lucy" is making people question whether we really use all our brainpower. But, as scientists have insisted for years, we do. Video provided by Newsy
Powered by NewsLook.com
Scientists Find New Way To Make Human Platelets

Scientists Find New Way To Make Human Platelets

Newsy (July 22, 2014) — Boston scientists have discovered a new way to create fully functioning human platelets using a bioreactor and human stem cells. Video provided by Newsy
Powered by NewsLook.com
Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) — New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins