Respiratory failure & ventilation
Preoperative Atelectasis in Patients with Obesity Undergoing Bariatric Surgery: A Cross-Sectional Study
Authors' conclusion
The prevalence and extension of atelectasis increased with higher BMI, being significantly higher at BMI ≥45 kg/m 2 . Preoperative atelectasis mediated the effect of BMI on Sp o2 at room air in the seated position.
Study context
- Population
- Patients with obesity undergoing laparoscopic bariatric surgery; preoperative chest CT
- Participants
- 236 patients
- Exposure
- Body mass index (BMI) categories
- Outcome
- Prevalence of preoperative atelectasis (≥2.5% of total lung volume on CT)
- Follow-up
- Preoperative
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Prevalence of atelectasis (overall 32.6%, 95% CI 27.0-38.9)
Each group vs 30 to 35 kg/m 2Adjusted prevalence ratio (95% CI)
45 to 50 kg/m 2E-value lower bound: 2.64
3.52(1.63–7.61)
≥50 kg/m 2E-value lower bound: 7.91
8.0(4.22–15.2)
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| Odds of greater atelectasis percentage coverage45 to 50 kg/m 2 vs 30 to 35 kg/m 2 | 7.5 (2.7–20.9) | |
| Odds of greater atelectasis percentage coverage≥50 kg/m 2 vs 30 to 35 kg/m 2 | 91.5 (30.0–279.3) | |
| 0.050.21520Adjusted odds ratio (log scale) |
Variation in preoperative SpO2 explained by atelectasis percent
- Variation in preoperative SpO2 explained by atelectasis percent alone
- 70.2%
Proportion of effect of BMI on preoperative SpO2 <96% mediated through atelectasis
- Proportion mediated
- 81.5% (95% CI, 56.0-100)
- Inverse probability weighting
Original publication
Preoperative Atelectasis in Patients with Obesity Undergoing Bariatric Surgery: A Cross-Sectional Study. Anesth Analg. Published 23 August 2024. doi:10.
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