Robert Goldstein, MD, executive vice president and chief medical officer, Somnia Anesthesia Services: Obesity and morbid obesity have well known associated co-morbidities. These include respiratory problems like restrictive lung disease, asthma and obstructive sleep apnea. Cardiac problems like hypertension, congestive heart failure and atherosclerotic heart disease. Endocrine problems like diabetes and hypercholesterolemia. GI disorders like liver disease and hiatal hernias. Obesity is even associated with a higher risk for cancers. But, perhaps most astounding is that the risk of premature death doubles with BMI greater than 35.
Weight cutoffs (or in this case BMI limits) that arbitrarily result in cancellations or transfers of patients to a hospital setting are never popular. In this situation, the decision to use a BMI of 39 or above as a determination for “additional screening” is very reasonable and it could be argued is in fact a bit liberal. The surgeons (even the ophthalmologists whose patients are perhaps at higher risk due to the anesthetist’s lack of access to the airway) should feel fortunate that their anesthesia group is protective of their patients’ safety and the center’s reputation.
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