Morbid obesity: postsurgical predictive factors and prioritization of the waiting list

To study a sample of patients with morbid obesity who are on the waiting list for a surgical intervention, to establish various scores of surgical risk (Possum and severity score), and to assess potential criteria for list prioritization.

We calculated physiological and surgical Possum scores for every patient, and analysed comorbidities and other associated factors to calculate the severity score. Likewise, we calculated the predictive rates of morbimortality. Differences between associated comorbidities in body mass index (BMI) were also analyzed. The correlation between Possum score, prediction rates, and severity score were analyzed.

Fifty-two patients on the surgical waiting list in our institution (San Juan University Hospital, Reus) from 26/4/02 to 5/03/04.

The mean qualitative score is significantly higher in the female sex. Invalidating arthropathy and socio-occupational and/or psychiatric criteria are significantly higher in women. There is a significant correlation between the severity score and Possum score. Age does not correlate with any of the variables studied.

Possum scores are significantly related to BMI, particularly in terms of morbidity rates. The degree of correlation between the Possum score and the qualitative score tells how useful the latter is to cover other determinant factors in the severity of this condition. Socio-occupational and psychiatric criteria, and invalidating arthropathy are the main variables to be taken into account for postsurgical prediction, and are directly related to BMI degree.