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Open Access 01-11-2017

Predicting postoperative complications after bariatric surgery: the Bariatric Surgery Index for Complications, BASIC

Authors: Usha K. Coblijn, Julian Karres, Christel A. L. de Raaff, Steve M. M. de Castro, Sjoerd M. Lagarde, Willem F. van Tets, H. Jaap Bonjer, Bart A. van Wagensveld

Published in: Surgical Endoscopy | Issue 11/2017

Abstract

Background

Around 20% of bariatric surgery patients develop a short- or long-term complication.

Objective

Aim of this study was to develop a risk model predicting complications: the Bariatric Surgery Index for Complications (BASIC).

Setting

The Obesity Center Amsterdam, located in a large teaching hospital, in Amsterdam, The Netherlands.

Methods

A prospective consecutive database including patients operated between November 2007 and February 2015 was used. For the BASIC, analysis according to the TRIPOD statement was performed to identify risk factors for complications. Class I included patients with zero to one risk factor, class II patients with two risk factors, and class III patients with three or more risk factors.

Results

Of 1709 analyzed patients, mean age was 45 years (±SD 10.7), 1393 (81.5%) were female; mean body mass index was 44.5 kg/m² (6.8). Overall, 271 (15.9%) patients developed a complication of which 197 (72.5%) occurred within 30 days. Predictors in multivariable analysis were use of anticoagulants (odd’s ratio (OR) 1.5); chronic obstructive pulmonary disease (OR 2.3); dyslipidemia (OR 1.4); gender (OR 1.4); psychiatric history (OR 1.3); and revisional surgery (OR 1.5). In class I, 13.5% (181 out of 1338) experienced complications, in class II 58 (21.6%) of the 269 patients and in class III 32 (31.4%) of the 102 patients, respectively. There was a significant difference (p < 0.001) in both overall and 30 day complications.

Conclusion

The BASIC uses six preoperative variables to classify patients in a low-, intermediate-, or high-risk group for postoperative complications after bariatric surgery.

Available only for authorised users

Buchwald H, (2013) Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg 23:427–436CrossRefPubMed

Colquitt JL, Pickett K, Loveman E et al (2014) Surgery for weight loss in adults. Cochrane Database Syst Rev 8:CD003641

World Health Organisation. Obesity and Overweight. http://www.who.int/mediacentre/factsheets/fs311/en/ August 2014; Accessed 14 Jan 2015

DeMaria EJ, Portenier D, Wolfe L (2007) Obesity surgery mortality risk score: proposal for a clinically useful score to predict mortality risk in patients undergoing gastric bypass. Surg Obes Relat Dis 3:134–140CrossRefPubMed

Efthimiou E, Court O, Sampalis J et al (2009) Validation of obesity surgery mortality risk score in patients undergoing gastric bypass in a canadian center. Surg Obes Relat Dis 5:643–647CrossRefPubMed

Sarela AI, Dexter SP, McMahon MJ (2011) Use of the obesity surgery mortality risk score to predict complications of laparoscopic bariatric surgery. Obes Surg 21:1698–1703CrossRefPubMed

Geubbels N, de Brauw LM, Acherman YI et al (2014) The preceding surgeon factor in bariatric surgery: a positive influence on the learning curve of subsequent surgeons. Obes Surg doi:10.1007/s11695-014-1538-x PubMed

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral

Zhang L, Tan WH, Chang R et al (2014) Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y gastric bypass. Surg Endosc doi:10.1007/s00464-014-3848-4

10.

Goitein D, Raziel A, Szold A et al (2015) Assessment of perioperative complications following primary bariatric surgery according to the Clavien-Dindo classification: comparison of sleeve gastrectomy and Roux-Y gastric bypass. Surg Endosc doi:10.1007/s00464-015-4205-y

11.

Anderin C, Gustafsson UO, Heijbel N et al (2015) Weight loss before bariatric surgery and postoperative complications: data from the Scandinavian Obesity Registry (SOReg). Ann Surg 261:909–913CrossRefPubMed

12.

Flum DR, Belle SH, King WC et al (2009) Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med 361:445–454CrossRefPubMed

13.

IFSO. IFSO: are you a candidate. http://www.ifso.com January 2015; Available from http://www.ifso.com Accessed 14 Jan 2015

14.

Coblijn UK, Lagarde SM, de Castro SM et al (2014) Symptomatic marginal ulcer disease after Roux-en-Y gastric bypass: incidence, risk factors and management. Obes Surg doi:10.1007/s11695-014-1482-9 PubMed

15.

Collins GS, Reitsma JB, Altman DG et al (2015) Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. BMJ 350:g7594CrossRefPubMed

16.

Lorente L, Ramon JM, Vidal P et al (2014) Obesity surgery mortality risk score for the prediction of complications after laparoscopic bariatric surgery. Cir Esp 92:316–323CrossRefPubMed

17.

Gupta PK, Franck C, Miller WJ et al (2011) Development and validation of a bariatric surgery morbidity risk calculator using the prospective, multicenter NSQIP dataset. J Am Coll Surg 212:301–309CrossRefPubMed

18.

Stenberg E, Szabo E, Agren G et al (2014) Early complications after laparoscopic gastric bypass surgery: results from the Scandinavian Obesity Surgery Registry. Ann Surg 260:1040–1047CrossRefPubMed

19.

Finks JF, Kole KL, Yenumula PR et al (2011) Predicting risk for serious complications with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg 254:633–640CrossRefPubMed

20.

Birkmeyer JD, Finks JF, O’Reilly A et al (2013) Surgical skills and complication rates after bariatric surgery. N Engl J Med 369:1434–1442CrossRefPubMed

21.

Kristensen SD, Naver L, Jess P et al (2014) Effect of closure of the mesenteric defect during laparoscopic gastric bypass and prevention of internal hernia. Dan Med J 61:A4854PubMed

Title: Predicting postoperative complications after bariatric surgery: the Bariatric Surgery Index for Complications, BASIC
Authors: Usha K. Coblijn
Julian Karres
Christel A. L. de Raaff
Steve M. M. de Castro
Sjoerd M. Lagarde
Willem F. van Tets
H. Jaap Bonjer
Bart A. van Wagensveld
Publication date: 01-11-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 11/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5494-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predicting postoperative complications after bariatric surgery: the Bariatric Surgery Index for Complications, BASIC

Abstract

Background

Objective

Setting

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Setting

Methods

Results

Conclusion

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