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The Edmonton Obesity Staging System: assessing a potential tool to improve the management of obesity surgery in the Brazilian public health services

HighlightsWhat is already known:1.Limited access to publicly-funded obesity surgery is a reality worldwide.2.Obesity classification systems to assess health status are alternative to BMI-defined criteria.3.Edmonton Obesity Staging System (EOSS) is reproducible and may be used to prioritize the waiting list for obesity surgery.4.Classifying candidates according to severity of obesity has been used by surgical services as a planning resource.What that study adds:1.No correlation was found between BMI-defined classes and EOSS stages.2.Aging was associated with presence and extent of obesity-related comorbidities.3.EOSS may be useful for disease severity classification before obesity surgery, making management of the waiting list more efficient.AbstractBackgroundLimited access to publicly funded, insurance-covered, and self-paid obesity surgery is a reality worldwide. Waiting lists for procedures are usually based on chronologic criteria and body mass index (BMI)-defined obesity categorization. Obesity classification systems assess overall health and have been proposed as an alternative.ObjectiveTo investigate the correlation between BMI-based classification and the Edmonton Obesity Staging System (EOSS) to support current evidence that the assessment of the clinical severity of obesity could be a helpful tool to maximize access to surgery.SettingUniversity hospital, Brazil.MethodsRetrospective analysis of all 2011 to 2014 adult patients who underwent obesity surgery under the public health system. Data on sex, age, presurgical BMI, and co-morbidities were extracted from hospital records. Spearman correlation coefficients were used to assess the strength and direction of the relationship between BMI classification and EOSS.ResultsOf 565 patients, 79% were female, mean age 44.1 ± 10.9 years and mean BMI 46.9 ± 6.2 kg/m2. The most common EOSS stage was 2 (86.5%), followed by stages 3 (8.5%) and 1 (4.9%). There was no correlation between the severity of obesity measured by BMI and EOSS (ρ = −.030, P = .475). Older patients had higher Edmonton scores (ρ = .308, P < .001). No difference was observed regarding sex.ConclusionsNo correlation was found between EOSS and BMI and between these and sex. Age correlated with both obesity indicators. EOSS was reproducible in Brazilian surgical patients and may be an important tool from a health services perspective contributing to the more efficient use of limited resources for obesity surgery.

سیستم تثبیت چاقی ادمونتون: ارزیابی یک ابزار بالقوه برای بهبود مدیریت جراحی چاقی در خدمات بهداشت عمومی برزیل

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