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Weight Loss Prior to Bariatric Surgery and 30-Day Mortality, Readmission, Reoperation, and Intervention: an MBSAQIP Analysis of 349,016 Cases

Obesity Surgery volume 29, pages 3622–3628 (2019)Cite this article

Abstract

Introduction

Despite preoperative weight loss being a common prerequisite to metabolic and bariatric surgery, its relationship to 30-day postoperative outcomes is unclear. The aim of this study was to assess whether preoperative weight loss is associated with 30-day postoperative quality outcomes in adults undergoing metabolic and bariatric surgery.

Methods

Retrospective cohort study assessing adults who underwent Roux-en-Y gastric bypass or sleeve gastrectomy in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant Use File, years 2015–2017. The relationship between preoperative weight loss and 30-day readmission, reoperation, mortality, intervention, and morbidity was assessed using multivariable logistic regression.

Results

Preoperative weight loss, body mass index loss, and percent weight loss were not associated with 30-day postoperative overall readmission, reoperation, mortality, or intervention (p > 0.01). Preoperative percent weight loss was associated with increased incidence of superficial surgical site infections (OR = 1.023, 95% CI 1.009–1.036; p = 0.001) and urinary tract infections (OR = 1.044, 95% CI 1.030–1.059; p < 0.001).

Conclusion

Weight loss prior to metabolic and bariatric surgery may not be necessary or safe for all patients. Unsafe weight loss prior to surgery may compromise nutrition status and lead to increased infection rates.

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Authors and Affiliations

  1. Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 4th Floor, Silverstein Building, Philadelphia, PA, 19104, USA

    Colleen Tewksbury, Julie M. Parrott, Elizabeth Smith & Kelly C. Allison

  2. Medical University of South Carolina, Charleston, SC, USA

    Nina Crowley

  3. Northwest Weight & Wellness Center, Everett, WA, USA

    Laura Andromalos

  4. Brigham and Women’s Hospital, Simmons University, Boston, MA, USA

    Kellene A. Isom

Authors
  1. Colleen Tewksbury
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  2. Nina Crowley
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  4. Laura Andromalos
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  5. Kellene A. Isom
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  6. Elizabeth Smith
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  7. Kelly C. Allison
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Correspondence to Colleen Tewksbury.

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Kelly C. Allison reports grants from Novo Nordisk and personal fees from Weight Watchers International.

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Tewksbury, C., Crowley, N., Parrott, J.M. et al. Weight Loss Prior to Bariatric Surgery and 30-Day Mortality, Readmission, Reoperation, and Intervention: an MBSAQIP Analysis of 349,016 Cases. OBES SURG 29, 3622–3628 (2019). https://doi.org/10.1007/s11695-019-04041-w

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  • DOI: https://doi.org/10.1007/s11695-019-04041-w

Keywords

  • Preoperative weight loss
  • MBSAQIP
  • Bariatric surgery