Preoperative Risk Scoring Systems in Bariatric Surgery

Abstract

Surgery on the morbidly obese patient can carry a high risk of peri-operative morbidity and mortality due to the unusual stress placed on the physiology of such patients. This risk is often increased because of pre-existing medical cardiorespiratory and metabolic comorbidities. This chapter discusses the preoperative risk scoring systems that are currently used in bariatric surgery, in order to identify and evaluate the morbidity and mortality risks for each patient. These risk scoring systems include the Obesity Surgery Mortality Risk Score (OSMRS), the Bariatric Mortality Risk (BMR), the Edmonton Obesity Staging System (EOSS), the Metabolic Acuity Score (MAS) and the Nomogram for predicting surgical complications. Other useful scoring or classification systems used include the Cardiac Risk Assessment for non-cardiac surgery system and the American Society of Anesthesiologists (ASA) physical status classification system. While there is no single ideal risk scoring system that caters to every patient, preoperative risk scoring systems are useful tools in planning a customized approach for each patient.