Feasibility of modified Edmonton Obesity Staging System in bariatric center

Abstract

Background: The number of bariatric procedures is growing worldwide annually. While there is no doubt that a high body mass index is fundamental in qualification for surgical intervention, the Edmonton Obesity Staging System (EOSS) developed in 2009 may be an additional tool for identifying patients for whom surgery should be performed and those for whom the surgery should be postponed.

Objective: Assessment of the feasibility of modified EOSS as a qualification tool for surgery for obesity and related diseases and its association with morbidity.

Setting: University Hospital, Jagiellonian University Medical College, Cracow, Poland.

Methods: A retrospective study of prospectively collected data. All patients were assigned an EOSS score based on their medical record. We only considered the medical aspect, so the achieved results may be underpowered. Analyzed outcomes involved specific and overall complication rate, length of hospital stay, and weight loss. Regression models were created to assess the influence of EOSS on length of stay and complications.

Results: We included 761 patients who were operated on between 2009 and 2018 in our department. Of these, 505 patients received sleeve gastrectomy and 256 patients received Roux-en-Y gastric bypass. The median EOSS score was 2, which was assigned to 80% of the patients. The analysis showed no influence of modified EOSS on peri- or postoperative outcomes. Additionally, there were no significant differences in the number of patients who achieved bariatric success. The follow-up rate at 1 year was 70%.

Conclusions: Our study suggests that modified EOSS score has no influence on the risk of developing complications and prolonged hospital stay. Patients with an EOSS score of ≥3 have higher major complication rate.

Keywords: Edmonton Obesity Staging System; Surgery for obesity and related diseases.