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Prevalence and Complications of Obesity in Surgical Patients: A Multicenter Study in Benin, a Sub-Saharan African Country

Zoumenou Eugene, Mensah Emile, Dossou Francis, Kaboro Mignagnal, Kerekou Annelie, Tchaou BLaise, Chobli Martin

Objective: To provide characteristics of an obese population that underwent anesthesia and surgery in a Sub- Saharan African country.

Patients and methods: 3971 Consecutive patients presenting for surgery and anesthesia over a four months period were screened. Obesity was defined as a BMI of at least 30 kg/m2. Obese patients were selected to determine the prevalence of obesity. Obese patients were followed from the intra operative period to at least the first 48 hours postoperatively. We analyzed demographic characteristics, anesthetic techniques and perioperative complications.

Results: BMI ≥ 30 was found in 384 patients. The prevalence of obesity in this population was 9.67%. Prevalence of obesity was higher in women (p < 10-6). The Mean age in obese patients was 41 years ± 15. The mean BMI was 34.77 ± 3.38. Mild obesity was found in 66% patients. Only 4% of obese patients had morbid obesity and there were no super-obese patients. Spinal anesthesia was used in 80% of the patients. Perioperative complications were observed in 67 patients (16%). There were cardiovascular complications (24 cases), respiratory complications (23 cases) or neurological complications (16 cases). Complications occurred more frequently during general anesthesia (26/75) than spinal (41/213). The difference was significant (p < 10-6). The risk of complications increased with increased BMI (p < 10-6).

Conclusion: Obesity is a concern for anesthetists in Benin although severity is less than reported in occidental literature. Main risk factors for perioperative complications are increasing BMI, general anesthesia and obstetrics.