An audit investigating BMI and the prevalence of obesity in orthognathic patients: Are we putting patients at risk?

Abstract

Introduction: The obese surgical patient presents a number of potential complications to surgeons and anaesthetists alike. We know that currently very few maxillofacial units in the country have a specific protocol in place for an upper BMI limit prior to operating. We hope to discuss the impact obesity has on orthognathic surgery and what can be done to minimise these risks. Methods: A retrospective analysis of the medical records of all 183 patients who had undergone orthognathic surgery from 2012-2015 at the Royal Derby Hospital was carried out, reviewing their BMIs and any intra- or post- operative complications. Results: Orthognathic surgery is being carried out frequently on clinically obese patients. Between 2012-2015, 10.7% of our surgical orthognathic patients had a BMI of greater than 30, of which 6.3% were greater than 35.We note one patient with a BMI greater than 30 who suffered a deep vein thrombosis post-operatively. Conclusion: As orthognathic surgery is elective and requires often lengthy courses of pre-operative orthodontics, there is a unique opportunity to encourage patients to achieve a healthy weight prior to surgery.We propose a guideline for the management of the obese patient seeking orthognathic surgery which we hope will reduce the number of high risk patients