New gastric bypass scoring system devised

Elisabethsew · September 6, 2006

Aug 28 (HealthCentersOnline) - Surgeons from Duke University Medical Center have devised a scoring system that can help predict which gastric bypass surgery candidates have the greatest risk of dying following the procedure.

food they are physically able to eat at one time. In addition, the digestive tract is altered so that food bypasses part of the stomach and part of the small intestine, resulting in fewer calories being absorbed by the body.

Gastric bypass surgery is generally a safe procedure. However, it poses the same risk of adverse side effects and death as any other type of surgery. At present, there is no way of determining which patients are most likely to die following the procedure.

To devise the scoring system, the surgeons retrospectively analyzed the outcomes of 2,075 gastric bypass surgeries at Virginia Commonwealth University between 1995 and 2004. They found that 1.5 percent (31) of the patients died within 90 days of the procedure.

After assessing the factors surrounding these deaths, the surgeons identified five patient characteristics that increase the risk of death following gastric bypass surgery. These include:

Body mass index (BMI) exceeding 50. BMI is a measure of a person's height and weight. It can be calculated by dividing a person's weight in kilograms by their height in meters squared. A BMI of 18.5 to 25 indicates a normal body weight.
Gender. Men are more prone to conditions such as diabetes, high blood pressure and metabolic disorder, all of which are associated with increased surgical risk.
High blood pressure. Patients with this condition also tend to have additional risk factors for adverse surgical outcomes, such as chronic inflammation of the blood vessels or heart disease.
Pulmonary embolus risk. Patients who have already experienced a pulmonary embolism (blood clot that can block blood flow to the lungs) or are at risk for developing one also have an increased surgical risk.
Age. Patients over age 45 have the greatest risk of death following bariatric surgery.

The scoring system assigns one point to each of these five patient characteristics. Therefore, patients with zero points generally fare the best and those with five points typically have the greatest risk.

If the findings are validated by additional studies, the scoring system will aid surgeons and patients in determining the best and safest course of treatment for obesity.

"Many people see gastric bypass surgery as an option to use only when all other approaches to weight loss have failed. However, our system shows that this strategy may need to be reconsidered. If patients put off surgery while they attempt other therapies that ultimately don't work, over time they risk moving into a higher-risk category as they gain more weight, get older or develop hypertension. In these cases, delays can make surgery even riskier," Dr. Eric DeMaria, of Duke University, said in a recent press release. DeMaria shared the results of the study at the 2006 annual meeting of the American Society for Bariatric Surgery in San Francisco.

Publish Date: August 28, 2006

libra · September 6, 2006

You know, I find that really interesting. Those people who are the most severely overweight and truly need the help, are the one's that are least likely to get the procedure.

My mom had a BMI of 50 and heart problems, she's going to my surgeon for banding. The surgeon said she wouldn't qualify for bypass but could for banding.

If it weren't for the band, what would people like my mom do?

Elisabethsew · September 6, 2006

I think if you are determined to have a surgery and are willing to "shop around" you can eventually find a surgeon to operate. Sad but true. I'm glad that your Mom explored her possibilities and has decided to go with the less invasive of weight loss surgeries. I also have a high BMI and a heart condition and did fine with the surgery.

pinkpanther06 · September 6, 2006

Hello, this is an interesting article, I had Mini Gastric Bypass 2 1/2 months ago with Dr. Felipe Cantu in Mexico, and I´ve lost 46 lbs. What I can tell you is that I eliminated from my diet all high carb foods such as breads, pastas, fatty foods, carbonated drinks, sweets, high sodium foods such as lean meats, beef, and lots more. I get full easy with a small amount of food, and now what I eat is fish, chicken, all high Protein foods and lots of veggies, which means I really changed my eating habits, now I don´t eat fatty foods, which is great, I feel great. But is everyone's own decision on having lap-band or gastric bypass.

sleepyjean · September 6, 2006

Is it me, or did the author just write an article about something we all know already? Drs are already trained to look at your medical history and risk factors. Is the guy saying that from now on, doctors will look at all of these things together? Because if they're not doing that already, I'd sure as heck like to know why.

NewSho · September 7, 2006

Hello, this is an interesting article, I had Mini Gastric Bypass 2 1/2 months ago with Dr. Felipe Cantu in Mexico, and I´ve lost 46 lbs.

Congrats on your weight loss.

What I can tell you is that I eliminated from my diet all high carb foods such as breads, pastas, fatty foods, carbonated drinks, sweets, high sodium foods such as lean meats, beef, and lots more.

Right, sounds good. Me, too. I don't eat beef, pork, red meat, bread, almost any starches and definitely don't drink sodas in any form.

I get full easy with a small amount of food, and now what I eat is fish, chicken, all high Protein foods and lots of veggies, which means I really changed my eating habits, now I don´t eat fatty foods, which is great

Me, too. Seafood, soy, complete Proteins dominate my food intake, rather than lots of fatty foods, empty carbs and worthless starches. I'm very pleased! :Banane27:

I feel great. But is everyone's own decision on having lap-band or gastric bypass.

Yes it is. In fact, many people here have decided to have the Lap-Band. It's wonderful that you found a procedure that works for you (I'm non-partisan about surgeries, frankly) although many patients with the LapBand here have achieved the same goals you have, and lost about the same amount of weight in approximately the same amount of time (or close to it).

So you gotta realize that to for those LapBanders who have lost about the same, with a shorter & generally less-complex surgery, with a quicker recovery time, and a lower serious-complication rate, they are feeling pretty good about their decision too.

Oh and it costs a lot less, also. I meet very few self-pay Mini-Bypass patients (obviously the Mexican version is more inexpensive) but the LapBand is affordable enough for many patients who pay or finance it, if the insurance companies let them down.

And speaking of, I know you had your surgery in Mexico which is a similarity to many Bandsters who were banded South-of-the-Border. But it kind of fascinates me. I mean, I've seen you post on a few threads where people are deciding on RnY-vs-Band and you're always upbeat, but... being a sweets eater alone does not necessarily make the RnY (or the 'mini bypass' RnY) a better choice than the band. :nervous

It's great that this particular rationale worked for you, but it's not a standard criteria as you've insinuated in some of your posts. Mini-bypass is not new, but it's not exactly the standard RnY operation, just as LapBanding isn't as common yet.

I mean, quite frankly, I think the original CLOS Mini-Bypass program here in the USA, is a good one, but bypass (even the 'mini-bypass' which is kind of a contradition in terms ) is just one of the great Weight Loss Surgery choices we have. :clap2:

Isn't choice great?

Enjoy your Weight Loss journey.

GeezerSue · September 7, 2006

Hello, this is an interesting article, I had Mini Gastric Bypass 2 1/2 months ago with Dr. Felipe Cantu in Mexico, and I´ve lost 46 lbs. What I can tell you is that I eliminated from my diet all high carb foods such as breads, pastas, fatty foods, carbonated drinks, sweets, high sodium foods such as lean meats, beef, and lots more. I get full easy with a small amount of food, and now what I eat is fish, chicken, all high Protein foods and lots of veggies, which means I really changed my eating habits, now I don´t eat fatty foods, which is great, I feel great. But is everyone's own decision on having lap-band or gastric bypass.

SPAM

Cantu sends recruiters here to solicit business...this is NOT the first one.

This is one the moderators should pull.