Preoperative comorbidities as a predictor of EBWL after bariatric surgery: a retrospective cohort study.

INTRODUCTION: The purpose of this study is to investigate the impact of preoperative comorbidities, including depression, anxiety, type 2 diabetes mellitus, obstructive sleep apnea, hypothyroidism, and the type of surgery on %EBWL (percent estimated body weight loss) in patients 1 year after bariatric surgery. Patients who choose to undergo bariatric surgery often have other comorbidities that can affect both the outcomes of their procedures and the postoperative period. We predict that patients who have depression, anxiety, diabetes mellitus, obstructive sleep apnea, or hypothyroidism will have a smaller change in %EBWL when compared to patients without any of these comorbidities. METHODS AND PROCEDURES: Data points were retrospectively collected from the charts of 440 patients from March 2012-December 2019 who underwent a sleeve gastrectomy or gastric bypass surgery. Data collected included patient demographics, select comorbidities, including diabetes mellitus, obstructive sleep apnea, hypothyroidism, depression, and anxiety, and body weight at baseline and 1 year postoperatively. Ideal body weight was calculated using the formula 50 + (2.3 × height in inches over 5 feet) for males and 45.5 + (2.3 × height in inches over 5 feet) for females. Excess body weight was then calculated by subtracting ideal body weight from actual weight at the above forementioned time points. Finally, %EBWL was calculated using the formula (change in weight over 1 year/excess weight) × 100. RESULTS: Patients who had a higher baseline BMI (p < 0.001), diabetes mellitus (p = 0.026), hypothyroidism (p = 0.046), and who had a laparoscopic sleeve gastrectomy rather than Roux-en-Y gastric bypass (p < 0.001) had a smaller %EBWL in the first year after bariatric surgery as compared to patients without these comorbidities at the time of surgery. Controversially, patients with anxiety or depression (p = 0.73) or obstructive sleep apnea (p = 0.075) did not have a statistically significant difference in %EBWL. CONCLUSION: A higher baseline BMI, diabetes mellitus, hypothyroidism, and undergoing laparoscopic sleeve gastrectomy may lead to lower %EBWL in the postoperative period after bariatric surgery. At the same time, patients' mental health status and sleep apnea status were not related to %EBWL. This study provides new insight into which comorbidities may need tighter control in order to optimize weight loss outcomes after bariatric surgery.

Designing Statistical Models for Holstein Rearing Heifers' Weight Estimation from Birth to 15 Months Old Using Body Measurements.

Body measurements could be used to estimate body weight (BW) with no need for a scale. The aim was to estimate heifers weight based on their body dimension characteristics. Twenty-five Holstein heifers represent the study group (SG); another 13 animals were evaluated as a validation group (VG). All the heifers were weighed (BW) and their wither height (WH), shin circumference (SC), heart girth circumference (HG), body length (BL), hip width (HW) and body condition score (BCS) were measured immediately after birth, and then weekly until 2 months and monthly until 15 months old. Equations were built with a stepwise regression in order to estimate the BW at each time using body measures for the SG. A linear regression was applied to evaluate the relationship between the estimated BW and the real BW. Equations found were to be statistically significant (r2 = 0.688 to 0.894; p < 0.0001). Three variables or fewer were needed for BW estimation a total of 11/23 times. Regression analysis indicated that the use of HG was promising in all the equations built for BW estimation. These models were feasible in the field; further studies will evaluate possible modifications to our equations based on different growing rate targets.

Accuracy of Patient Height, Weight and Ideal Body Weight Estimates in the Emergency Department.

CONTEXT: The purpose of this study was to establish the accuracy of emergency medicine professionals' estimates of a sample of patients' heights, weights and ideal body weights (IBW). METHODS: This was a cross-sectional survey study with 69 emergency medicine professionals concerning estimates of five standardized patients. Board-certified emergency physicians, emergency medicine residents and emergency department nurses were asked to estimate patient height, weight and (IBW) by looking at a series of photographs of five standardized patients with varied body types. Repeated measure analysis of variance procedures were used to examine for estimates-to-actual measurement differences. RESULTS: Overall height, weight and IBW estimate differences did vary significantly for the majority of the five standardized patients. Respondents' clinical position (i.e., attending physician, resident, or nurse) and years of clinical experience did show a significant level of influence on estimate-to-actual differences for some proportion of patient estimates. CONCLUSION: Our results support the common belief that the accuracy of overall weight and height estimates in emergency department settings is unacceptably low, and that a patient's stated weight and height is likely to be more accurate. Further work is required in this area of emergency medicine practice since these types of inaccuracies could potentially compromise the effectiveness of therapies and treatments during emergent situations.