Assessment of obesity-related comorbidities: A novel scheme for evaluating bariatric surgical patients

BACKGROUND: Bariatric surgery serves as the superior means of achieving sustained weight loss and improvement in obesity-related comorbidities. Results of bariatric surgery have been reported qualitatively without standardized measurement of comorbidity response. The objective of this work was to develop a clinically based, standardized system for scaled assessment of the major comorbidities of obesity in patients undergoing bariatric surgery. STUDY DESIGN: We constructed a standardized grading scheme for the major comorbidities of obesity, with each condition scored from 0 to 5, according to severity. Data were prospectively collected on 226 patients. Ninety patients have already undergone gastric bypass and are being followed at regular intervals postoperatively. Longest current followup interval is 1 year. RESULTS: Preoperative evaluation of comorbidities identified a total of 1,356 medical disorders. Anatomic comorbidities were most prevalent as a category, although psychosocial impairment was the most common single condition. The majority of comorbidities in our patient population were graded mild (score of 1) to moderate (score of 3). Immediate (2 weeks) followup was available for all operated patients and ranged in number to 1 year postoperatively, depending on the date of operation. Statistically significant reduction in the severity of several comorbidities was observed at postoperative evaluation (p < 0.05). CONCLUSIONS: This scheme for assessment of obesity-related comorbidities facilitates evaluation of bariatric surgical patients. The system allows standardized preoperative characterization of a bariatric patient population and uniform postoperative longitudinal assessment of changes in comorbidities after weight reduction operation.