Features of referral to medical and social expertiseof obesity patients
ORIGINAL PAPERS
Abstract
Introduction.In the presence of persistent dysfunctions of target organs, patients with morbid obesity are referred for medical and social examination, and in the “Referral for medical and social examination by a medical organization” (form No. 088u) it is necessary to indicate the patient’s clinical and functional data as fully as possible.Aim — to study is to examine the nature and severity of persistent dysfunction of target organs in patients with morbid obesity referred to the bureau of medical and social expertise.Materials and methods.A retrospective analysis of clinical and expert documents was performed for 30 patients with morbid obesity recognized as disabled. There were 16 women (53.3%) and 14 men (46.7%). The average age was 55.0±6.7 years. The average body mass index was 50.8 kg/m2. All patients received treatment for concomitant diseases; obesity treatment was performed only in 3 (10%) cases.Results.All patients had obesity - associated pathology: cardiovascular diseases (100%), carbohydrate metabolism disorders (63.3%), non - inflammatory lesions of large joints (46.7%), alveolar hypoventilation syndrome with respiratory failure (23.3%), chronic kidney disease (20%). During examination at the Bureau of Medical and Social Expertise, all patients were found to have persistent dysfunctions of the body from moderate to severe, as well as limitations of life activities in the following categories: of self - care, independent movement, work activity of 1–3 degrees. Disability group III was established in 19 patients (63%), group II — in 7 patients (23%), group I — in 4 cases (14%).Conclusion.Indications for referral to a medical and social assessment bureau for patients with morbid obesity include moderate, severe, or significant impairment of the cardiovascular, respiratory, urinary, digestive, and musculoskeletal systems, as well as significant chronic diabetic complications. The lack of medical rehabilitation for obese patients referred for medical and social assessment complicates expert - rehabilitation diagnostics, determining disability status, and determining the necessary comprehensive rehabilitation measures.
References
1. Тимофеев Ю.С., Джиоева О.Н., Драпкина О.М. Биологические маркеры при ожирении: фундаментальные и клинико - лабораторные аспекты. М.: ФГБУ НМИЦ ТПМ Минздрава России, РОПНИЗ, Силицея - Полиграф. 2024. https://doi.org/10.15829/ROPNIZ-t1-2024.
2. Ким О.Т., Драпкина О.М. Эпидемия ожирения через призму эволюционных процессов. Кардиоваскулярная терапия и профилактика. 2022. 21(1):72–79. https://doi.org/10.15829/1728-8800-2022-3109.
3. Ожирение. Клинические рекомендации. М. 2024.
4. Сафиуллина А.А., Ускач Т.М., Сайпудинова К.М., Терещенко С.Н., Чазова И.Е. Сердечная недостаточность и ожирение. Терапевтический архив. 2022. 94(9):1115–1121. https://doi.org/10.26442/00403660.2022.09.201837.
5. Репкина Т.В., Гатаулина О.В., Демина Е.И. Проблемы ожирения в структуре факторов риска хронической сердечной недостаточности на территориальном терапевтическом участке. Современные проблемы науки и образования. 2022. (4):137–137. https://doi.org/10.17513/spno.31792.
6. Cotter G., Petrie M.C., Butler J., Davison B., Chioncel O., Biegus J. et al. Obesity and inflammation in chronic and acute heart failure. Heart Fail Rev. 2025. 30(5):923–930. https://doi.org/10.1007/s10741-025-10518-x.
7. Хроническая сердечная недостаточность. Клинические рекомендации. М. 2024.
8. Абусева Г.Р., Ковлен Д.В., Пономаренко Г.Н., Хозяинова С.С., Адхамов Б.М., Иващев В.В. и др. Физические методы реабилитации пациентов с остеоартрозом: наукометрический анализ доказательных исследований. Травматология и ортопедия России. 2020. 26(1):190–200. https://doi.org/10.21823/2311-2905-2020-26-1-190-200.
9. Ялтонский В.М., Абросимов И.Н., Сирота Н.А., Ялтонская А.В., Панченкова М.Д. Динамика восприятия болезни и саморегуляции у пациентов с морбидным ожирением через три месяца после бариатрической хирургии. Консультативная психология и психотерапия. 2024. 32(3):28–47. https://doi.org/10.17759/cpp.2024320302.
10. Пономаренко Г.Н. Физическая и реабилитационная медицина: фундаментальные основы и клиническая практика. Физиотерапия, бальнеология и реабилитация. 2016. 15(6):284–289. https://doi.org/10.18821/1681-3456-2016-15-6-284-289.
11. Разумов А.Н., Ежов В.В., Довгань И.А., Пономаренко Г.Н. Лечебные эффекты климатотерапии: наукометрический анализ доказательных исследований. Вопросы курортологии, физиотерапии и лечебной физической культуры. 2020. 97(6):59–67. https://doi.org/10.17116/kurort20209706159.
