Bariatric Surgery: Severity, Level of Control, and Time Required for Preoperative Asthma Control

• Published in: Obesity surgery 2013-03, Vol.23 (3), p.372-378
• Main Author: Melo, Saulo Maia d’Avila
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - therapeutic use; Adult; Asthma; Asthma - drug therapy; Asthma - physiopathology; Bariatric Surgery; Brazil - epidemiology; Bronchodilator Agents - administration & dosage; Bronchodilator Agents - therapeutic use; Clinical Research; Drug Administration Schedule; Female; Forced Expiratory Volume; Gastrointestinal surgery; Humans; Male; Medicine; Medicine & Public Health; Obesity; Obesity, Morbid - physiopathology; Obesity, Morbid - surgery; Preoperative Care; Prospective Studies; Severity of Illness Index; Surgery
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-012-0776-z

Background There is an increased prevalence of asthmatic, obese patients undergoing bariatric surgery. The objective of our study is to evaluate the severity, level of control, respiratory medication use, and time required for prebariatric surgery asthma control. Methods This is a prospective study in which 88 obese asthmatics were evaluated by a pulmonologist in two steps, prebariatric surgery. In the first step, patients were evaluated for severity, level of control, and respiratory medication in use, categorized as bronchodilators and corticosteroids. In the second step, the time required for asthma control between steps and appropriate respiratory medication was determined. Results Thirty-eight obese patients (43.2%) had intermittent asthma, 22 had mildly persistent (25.0%), 24 moderately persistent (27.3%), and 4 severely persistent (4.5%). There were 43 patients with controlled asthma (48.9%), 31 partly controlled (35.2%), and 14 uncontrolled (15.9%). The study sample showed a significant increase in bronchodilators in the first step and corticosteroids in the second step ( p  ≤ 0.0001). Comparisons between steps showed significant differences with a reduction of bronchodilators and increase in corticosteroids in the second step ( p  ≤ 0.0001). The mean time (days) required for asthma control between steps was 28.98 ± 33.40 days, with significant differences between groups ( p  ≤ 0.001). Conclusions In prebariatric surgery, there was a higher proportion of intermittent asthma and uncontrolled asthma, with asthma severity influencing the achievement of asthma control and the time required for surgical release.