RESUMO
BACKGROUND: Individuals classified as morbidly obese require effective treatments to promote weight reduction. Due to the inefficacy of conservative treatments and current medications, bariatric surgery (gastric bypass) has been indicated for this group of individuals. AIM: To identify subgroups of obese patients in order to find patterns that hinder weight loss and recovery after the operation. METHOD: Variables from the medical records of 50 patients were analyzed at two different times: before bariatric surgery and six months after the surgery, utilizing statistical cluster analysis. RESULTS: The analysis led to dividing the patients into two groups. The body mass index - BMI variable did not influence the classification of the patients. The group in worse metabolic conditions was not necessarily composed of heavier subjects, but the cluster analysis grouped the patients according to four indicators of metabolic syndrome. Metabolic alterations and blood pressure were shown to have a clear correlation to obesity, relation to BMI was not confirmed by this study. CONCLUSIONS: Taking measures to manage metabolic syndrome and not focusing solely on weight loss could improve recovery after bariatric surgery, considering that the BMI was reduced in all patients and was not the distinguishing factor for the postoperative period.
Assuntos
Derivação Gástrica , Obesidade/classificação , Obesidade/cirurgia , Adulto , Análise por Conglomerados , Feminino , Derivação Gástrica/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Redução de Peso , Adulto JovemRESUMO
RACIONAL: Indivíduos classificados como obesos mórbidos necessitam de tratamentos eficientes para promover a redução de peso. Em consequência da ineficácia dos tratamentos conservadores e medicamentos atuais, a operação de Fobi-Capella (gastric bypass) tem sido indicada para esse grupo de indivíduos. OBJETIVO: Identificar subgrupos de pacientes obesos com a finalidade de encontrar padrões que dificultem a perda de peso e a recuperação dele após essa operação. MÉTODO: Foram analisadas variáveis dos prontuários de 50 pacientes em dois momentos distintos: antes da operação bariátrica e após seis meses utilizando a metodologia estatística de Análise de Agrupamentos. RESULTADOS: A análise propiciou a divisão dos pacientes em dois grandes grupos. A variável IMC não influenciou na divisão dos pacientes. O grupo em piores condições metabólicas não foi necessariamente formado pelos indivíduos mais obesos, porém a Análise de Agrupamento associou os pacientes de acordo com quatro indicativos da síndrome metabólica. Houve clara relação entre as alterações metabólicas e de pressão arterial com a obesidade, porém neste estudo não se verificou dependência direta em relação ao IMC. CONCLUSÕES: As medidas que poderiam incrementar a recuperação após cirurgia bariátrica visam o controle da síndrome metabólica e não apenas a perda de peso, visto que o IMC foi reduzido em todos os pacientes e não foi o fator diferencial do pós-operatório.
BACKGROUND: Individuals classified as morbidly obese require effective treatments to promote weight reduction. Due to the inefficacy of conservative treatments and current medications, bariatric surgery (gastric bypass) has been indicated for this group of individuals. AIM: To identify subgroups of obese patients in order to find patterns that hinder weight loss and recovery after the operation. METHOD: Variables from the medical records of 50 patients were analyzed at two different times: before bariatric surgery and six months after the surgery, utilizing statistical cluster analysis. RESULTS: The analysis led to dividing the patients into two groups. The body mass index - BMI variable did not influence the classification of the patients. The group in worse metabolic conditions was not necessarily composed of heavier subjects, but the cluster analysis grouped the patients according to four indicators of metabolic syndrome. Metabolic alterations and blood pressure were shown to have a clear correlation to obesity, relation to BMI was not confirmed by this study. CONCLUSIONS: Taking measures to manage metabolic syndrome and not focusing solely on weight loss could improve recovery after bariatric surgery, considering that the BMI was reduced in all patients and was not the distinguishing factor for the postoperative period.