Patient Risk Factors Associated with Increased Morbidity and Mortality Following Revisional Laparoscopic Bariatric Surgery for Inadequate Weight Loss or Weight Recidivism: an Analysis of the ACS-MBSAQIP Database

Ivy N. Haskins, Erik J. DeAngelis, Jacob Lambdin, Richard L. Amdur, Hope T. Jackson, Khashayar Vaziri

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Revisional bariatric operations are associated with increased morbidity and mortality compared with primary bariatric operations. The purpose of this study was to determine if preoperative patient variables are associated with an increased risk of 30-day morbidity and mortality following revisional laparoscopic bariatric surgery for inadequate weight loss or weight recidivism and to generate expected model probabilities in order to risk stratify individual patients undergoing these operations. Materials and Methods: All patients undergoing revisional laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) from 2015 to 2016 were identified with the American College of Surgeons Metabolic and Bariatric Surgery Quality Improvement Program (ACS-MBSAQIP) database. The association of preoperative patient variables with 30-day morbidity and mortality was investigated using multivariable logistic regression analysis. Predictive outcome models were developed for each outcome of interest. Results: A total of 13,551 patients met inclusion criteria; 5310 (39.2%) underwent revisional RYGB. Each of the available preoperative variables was associated with one or more of the 30-day morbidity and mortality outcomes of interest. The strength of the predictive models, as reflected by the area under the curve, ranged from 0.63 for 30-day unplanned hospital readmission to 0.92 for cardiac events. Conclusion: Preoperative patient and surgical variables are associated with an increased risk of 30-day morbidity and mortality following laparoscopic revisional bariatric surgery. With these results, we have built a risk calculator that can be used as a resource for prehabilitation and patient counseling prior to revisional bariatric surgery.

Original languageEnglish (US)
Pages (from-to)4774-4784
Number of pages11
JournalObesity Surgery
Volume30
Issue number12
DOIs
StatePublished - Dec 2020

Keywords

  • Bariatric surgery
  • Morbidity
  • Mortality
  • Revisional surgery

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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