Scholarlink

Background <p>BMI is widely used as a primary criterion for prioritizing candidates for metabolic surgery. However, it may not fully capture disease severity or mortality risks associated with comorbidities such as type 2 diabetes (T2D) and cardiovascular disease (CVD). This study aimed to assess whether BMI accurately reflects disease burden and risk in patients undergoing metabolic surgery.</p> Methods <p>A retrospective audit included 723 adult candidates for primary metabolic surgery at a tertiary care center between January 2014 and December 2022. Patients undergoing revisional surgeries were excluded. Clinical data, including demographics, comorbidities, and disease severity indicators (e.g., ASA score, Charlson Comorbidity Index [CCI], medication usage, and estimated 10-year survival), were analyzed. Patients were grouped by BMI (&lt; or ≥ 50&#xa0;kg/m<sup>2</sup>), T2D, and CVD status for comparison.</p> Results <p>Prevalence rates for T2D, BMI ≥ 50&#xa0;kg/m<sup>2</sup>, and CVD were 41.6%, 37.3%, and 16.2%, respectively. Patients with BMI ≥ 50&#xa0;kg/m<sup>2</sup> were generally younger, had fewer comorbidities, lower CVD prevalence, and better estimated 10-year survival than those with BMI &lt; 50&#xa0;kg/m<sup>2</sup>. In contrast, patients with T2D and CVD had significantly higher ASA and CCI scores, greater medication usage, and reduced 10-year survival (<i>p</i> &lt; 0.001 for T2D; <i>p</i> &lt; 0.01 for CVD).</p> Conclusion <p>Higher BMI levels do not reflect greater disease burden and mortality risk among candidates for bariatric/metabolic surgery. These findings do not support the use of high BMI-based thresholds (e.g., ≥ 50&#xa0;kg/m<sup>2</sup>) as criteria for expedited access. Clinically relevant measures of baseline disease burden should be used to determine the urgency of access to surgical treatment of obesity and T2D.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Disease-Based Criteria vs BMI Level for Prioritization of Metabolic Surgery

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年5月17日

查看全文
  • Pia Roser,
  • Robert D. McIntyre,
  • Simone Cremona,
  • Adel Assiri,
  • Lyz Bezerra Silva,
  • Ghassan Chamseddine,
  • Francesco Rubino

摘要

Background

BMI is widely used as a primary criterion for prioritizing candidates for metabolic surgery. However, it may not fully capture disease severity or mortality risks associated with comorbidities such as type 2 diabetes (T2D) and cardiovascular disease (CVD). This study aimed to assess whether BMI accurately reflects disease burden and risk in patients undergoing metabolic surgery.

Methods

A retrospective audit included 723 adult candidates for primary metabolic surgery at a tertiary care center between January 2014 and December 2022. Patients undergoing revisional surgeries were excluded. Clinical data, including demographics, comorbidities, and disease severity indicators (e.g., ASA score, Charlson Comorbidity Index [CCI], medication usage, and estimated 10-year survival), were analyzed. Patients were grouped by BMI (< or ≥ 50 kg/m2), T2D, and CVD status for comparison.

Results

Prevalence rates for T2D, BMI ≥ 50 kg/m2, and CVD were 41.6%, 37.3%, and 16.2%, respectively. Patients with BMI ≥ 50 kg/m2 were generally younger, had fewer comorbidities, lower CVD prevalence, and better estimated 10-year survival than those with BMI < 50 kg/m2. In contrast, patients with T2D and CVD had significantly higher ASA and CCI scores, greater medication usage, and reduced 10-year survival (p < 0.001 for T2D; p < 0.01 for CVD).

Conclusion

Higher BMI levels do not reflect greater disease burden and mortality risk among candidates for bariatric/metabolic surgery. These findings do not support the use of high BMI-based thresholds (e.g., ≥ 50 kg/m2) as criteria for expedited access. Clinically relevant measures of baseline disease burden should be used to determine the urgency of access to surgical treatment of obesity and T2D.