Abstract
Background
This study aimed to evaluate the role of the Obesity Surgery Mortality Risk Score (OS-MRS) to predict the risk of post-operative adverse events, in addition to death, from any laparoscopic bariatric procedure.
Methods
The OS-MRS was applied to consecutive patients at a single hospital during October 2008–September 2009. The composite end point comprised one or more of the following adverse events: mortality, re-intervention, re-admission to hospital, venous thromboemobolism, or blood transfusion.
Results
There were 381 patients (men, 19%). The median age was 43 years (range, 19–67 years), with 42% patients aged ≥45 years. The median weight was 126 kg (75–295 kg) and median BMI 46 kg/m2 (30–84 kg/m2); 37% had BMI ≥50 kg/m2. Twenty-seven percent of patients had hypertension and 3% had a past history of venous thromboembolism. The OS-MRS classes were A (60.1%), B (35.9%), or C (4.0%). Operations comprised adjustable gastric band (37%), Roux-en-Y gastric bypass (54%), sleeve gastrectomy (8%), or biliopancreatic diversion (1%). Of the operations, 1.6% were revisional procedures. An adverse outcome occurred in 19 patients, with distribution in 3.5% of class A patients, 5.8% of class B, and 20.0% of class C (A vs. B, P = 0.451; A vs. C, P = 0.002; B vs. C, P = 0.025). There was one death: OS-MRS class C. On multivariate analysis, OS-MRS (class C vs. A or B; Odds Ratio [OR], 4; P = 0.050) and type of operation (band vs. bypass or sleeve; OR, 9.2; P = 0.033) were independently predictive of the composite end point.
Conclusion
OS-MRS and type of the bariatric operation are independently predictive of the risk of post-operative adverse events.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Murr MM, Martin T, Haines K, et al. A state-wide review of contemporary outcomes of gastric bypass in Florida: does provider volume impact outcomes? Ann Surg. 2007;245(5):699–706.
Nguyen NT, Paya M, Stevens CM, et al. The relationship between hospital volume and outcome in bariatric surgery at academic medical centers. Ann Surg. 2004;240(4):586–93.
Ghaferi AA, Birkmeyer JD, Dimick JB. Variation in hospital mortality associated with inpatient surgery. N Engl J Med. 2009;361(14):1368–75.
DeMaria EJ, Portenier D, Wolfe L. Obesity surgery mortality risk score: proposal for a clinically useful score to predict mortality risk in patients undergoing gastric bypass. Surg Obes Relat Dis. 2007;3(2):134–40.
DeMaria EJM, Murr MM, Byrne TKM, et al. Validation of the Obesity Surgery Mortality Risk Score in a multicenter study proves it stratifies mortality risk in patients undergoing gastric bypass for morbid obesity. Ann Surg. 2007;246(4):578–84.
Efthimiou E, Court O, Sampalis J, et al. Validation of Obesity Surgery Mortality Risk Score in patients undergoing gastric bypass in a Canadian center. Surg Obes Relat Dis. 2009;5(6):643–7.
The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361(5):445–54.
Blackstone RP, Cortes MC. Metabolic acuity score: effect on major complications after bariatric surgery. Surg Obes Relat Dis. 2010;6(3):267–73.
DeMaria EJ, Pate V, Warthen M, et al. Baseline data from American Society for Metabolic and Bariatric Surgery-designated Bariatric Surgery Centers of Excellence using the Bariatric Outcomes Longitudinal Database. Surg Obes Relat Dis. 2010;6(4):347–55.
Lancaster RT, Hutter MM. Bands and bypasses: 30-day morbidity and mortality of bariatric surgical procedures as assessed by prospective, multi-center, risk-adjusted ACS-NSQIP data. Surg Endosc. 2008;22(12):2554–63.
Brethauer S, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as a staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469–75.
Ching SS, Sarela AI, Dexter SP, et al. Comparison of early outcomes for laparoscopic ventral hernia repair between nonobese and morbidly obese patient populations. Surg Endosc. 2008;22(10):2244–50.
Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187–96.
Welbourn R, Walton A. Second Quarterly Industry Report. National Bariatric Surgery Registry. 2010.
Inabnet WB, Belle SH, Bessler M, et al. Comparison of 30-day outcomes after non-LapBand primary and revisional bariatric surgical procedures from the Longitudinal Assessment of Bariatric Surgery study. Surg Obes Relat Dis. 2010;6(1):22–30.
Petersen RP, Portenier DD, Pryor AD, et al. Prospective application of the obesity surgery mortality risk score (OS-MRS) may improve outcomes in high-risk patients undergoing bariatric surgery. Surg Obes Relat Dis. 2010;5:S81–8.
Conflicts of Interest
None of the authors have conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
The data contained in this paper were the subject of an oral presentation to the plenary of the British Obesity and Metabolic Surgery Society (BOMSS) at the meeting in January, 2010; Croydon, UK.
Rights and permissions
About this article
Cite this article
Sarela, A.I., Dexter, S.P.L. & McMahon, M.J. Use of the Obesity Surgery Mortality Risk Score to Predict Complications of Laparoscopic Bariatric Surgery. OBES SURG 21, 1698–1703 (2011). https://doi.org/10.1007/s11695-011-0379-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-011-0379-0