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The prevalence of overweight and obesity is escalating in Western countries, making it the second leading cause of preventable death after tobacco use. Obese individuals face higher cardiovascular risk and surgical complications, prompting specific pre-operative assessments for those undergoing non-cardiac surgery. Recommendations include evaluating cardiorespiratory fitness and considering additional investigations for patients at high risk of obesity hypoventilation syndrome.

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sorbant1980
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7 views1 page

١

The prevalence of overweight and obesity is escalating in Western countries, making it the second leading cause of preventable death after tobacco use. Obese individuals face higher cardiovascular risk and surgical complications, prompting specific pre-operative assessments for those undergoing non-cardiac surgery. Recommendations include evaluating cardiorespiratory fitness and considering additional investigations for patients at high risk of obesity hypoventilation syndrome.

Uploaded by

sorbant1980
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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The preva­lence of over­weight and obe­si­ty is reach­ing epi­dem­ic pro­por­tions in West­ern coun­tries, and is the sec­ond lead­ing

cause of pre­ventable death fol­low­ing to­bac­co use. Obe­si­ty is de­fined as a body mass in­dex (BMI) of ≥30 kg/​m2 or greater,
mor­bid obe­si­ty as a BMI ≥35 kg/​m2, and su­per-​mor­bid obe­si­ty as a BMI ≥50 kg/​m2. Obese in­di­vid­ua­ ls have a high­er preva­‐
lence of CV risk fac­tors and a high­er risk of death, and are a pop­ul­a­tion who are at in­creased risk of ad­verse events in the
case of sur­gi­cal pro­ce­dures.

On the one side, there ex­ist spe­cif­ic rec­om­men­da­tions for the pre-​op­er­a­tive risk as­sess­ment of obese pa­tients un­der­go­ing
NCS, re­gard­less of the pres­ence of pre-​ex­ist­ing car­diac con­di­tions. On the oth­er side, while obe­si­ty ac­cel­er­ates the propen­‐
si­ty for CVD, it seems that many types of CVD may have a bet­ter prog­no­sis in the over­weight pop­ul­a­tion com­pared with their
lean­er coun­ter­parts, a phe­nomenon that is known as the ‘obe­si­ty para­dox'.

Rec­om­men­da­tions for man­age­ment of pa­tients with obe­si­ty un­der­go­ing non-​car­diac surgery

Rec­om­men­da­tions Classa Lev­ela

It is rec­om­mend­ed to as­sess car­diores­pi­ra­to­ry fit­ness to es­ti­mate pe­‐


ri­op­er­a­tive CV risk in the obese pa­tient, with par­tic­ul­ar at­ten­tion to I B
those un­der­go­ing in­ter­me­di­ate and high-​risk NCS.

In pa­tients at high risk of obe­si­ty hy­poven­ti­la­tion syn­drome, ad­di­tion­‐


al spe­cial­ist in­ves­ti­ga­tion be­fore ma­jor elec­tive NCS should be con­‐ IIa C
sid­ered.

CV, cardiovascular; NCS, non-​car­diac surgery.


a
Class of rec­om­men­da­tion and lev­el of ev­i­dence as de­fined in Ta­bles 1 and 2.

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