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

Abstract Background Limited access to publicly-funded, insurance-covered and self-paid obesity surgery is a reality worldwide. Waiting lists for procedures are usually based on chronological criteria and body mass index (BMI)-defined obesity categorization. Obesity classification systems assess overall health and have been proposed as an alternative. Objective To 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. Setting University hospital, Brazil. Methods Retrospective analysis of all 2011-2014 adult patients who underwent obesity surgery under the public health system. Data on gender, age, presurgical BMI and comorbidities were extracted from hospital records. Spearman correlation coefficients were used to assess the strength and direction of the relationship between BMI classification and EOSS. Results Of 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=-0.030, p=0.475). Older patients had higher Edmonton scores (ρ=0.308, p Conclusions No correlation was found between EOSS and BMI and between these and gender. 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.