Postoperative Adverse Events in Morbidly Obese Patients Undergoing Anesthesia: A Retrospective Study
Arunotai Siriussawakul MD*, Pattana Kaewprasit MD**, Napak Rodprasert MD*, Pawinee Choonoy MD*
Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Anesthesiology, Buddhachinaraj Hospital, Phitsanulok, Thailand
Objective : To determine the incidence of postoperative respiratory complications among morbidly obese patients who had
undergone anesthesia.
Material and Method: This retrospective chart review was conducted at two centers, Siriraj Hospital and Buddhachinaraj
Hospital. Adult in-patients aged greater than or equal to 18, with a body mass index (BMI) greater than or equal to 35 kg/m2,
and who had undergone non-cardiac surgery and anesthesia, were enrolled. The postoperative respiratory adverse events,
such as pneumonia, pulmonary embolism, re-intubation, airway obstruction and airway trauma, were recorded.
Results : A total of 830 medical records of morbidly obese patients who had been admitted at the two medical centers between
October 2013 and December 2016 were retrieved. Around two-thirds of patients were female. The patients’ mean age was
46.4 years old (the maximum was 98, and the minimum 18), with a mean BMI of 38.83 kg/m2 (the maximum was 78.5 kg/m2,
and the minimum 35 kg/m2). The overall perioperative respiratory adverse events numbered 37 (4.5%). The postoperative
respiratory adverse event was re-intubation (0.5%); the remaining postoperative respiratory adverse events were pneumo-
nia (0.1%) and upper airway obstruction (0.1%). All those cases had undergone general anesthesia, and their American
Society of Anesthesiologists (ASA) Physical Status classification was greater than, or equal to, class 3.
Conclusion : The incidence of postoperative respiratory adverse events was minimal; therefore, risk factors were unable to
be identified.
Keywords : Morbid obesity anesthesia, Postoperative pulmonary, Anesthesia adverse events
