Skip to main content
SpringerLink
Log in

Failure of the Obesity Surgery Mortality Risk Score (OS-MRS) to Predict Postoperative Complications After Bariatric Surgery. A Single-Center Series and Systematic Review

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

The obesity surgery mortality risk score (OS-MRS) was developed to determine the risk of postoperative mortality in patients undergoing bariatric surgery. The aim of the present study is to assess the utility of this score for preventing the risk of postoperative complications from bariatric surgery.

Methods

Prospective study of 321 patients undergoing bariatric surgery to whom the OS-MRS was applied. Postoperative complications were classified according to the Clavien-Dindo system. The relation between the OS-MRS and the appearance of complications and mortality was analyzed. A Medline/Embase search was conducted using bariatric surgery, mortality, and complications as key words. Studies using the OS-MRS to predict morbidity and mortality were included.

Results

Of the 321 patients, 303 (94.3%) underwent gastric bypass and the remaining 18 (5.6%) a sleeve gastrectomy. The OS-MRS classified 178 patients as class A (55.5%), 129 as class B (40.2%), and 14 as class C (4.4%). According to the Clavien-Dindo system, 10.4% of the complications were ≥III. There was one death (class B). No significant association was found between the OS-MRS and the rate of complications.

Conclusions

In our study, the OS-MRS is not correlated with the appearance of early complications or mortality. Future studies must focus on systems for predicting the appearance and severity of postoperative complications classified according to the Clavien-Dindo system, and not only on mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alastrue A, Rull M, Casas D, et al. Obesidad mórbida. Reflexiones sobre un protocolo quirúrgico (I) Protocolo clínico y preoperatorio. Nutr Hosp. 1995;10(6):307–20.

    CAS  PubMed  Google Scholar 

  2. Morales MJ, Díaz-Fernández MJ, Caixàs A, et al. Grupo de Trabajo sobre Obesidad de la Sociedad Española de Endocrinología y Nutrición. Medical issues of surgical treatment of obesity. Med Clin (Barc). 2012;138(9):402–9.

    Article  Google Scholar 

  3. Pories WJ. Bariatric surgery: risks and rewards. J Clin Endocrinol Metab. 2008;93(11 suppl 1):S89–96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Le Gall JR, Lemeshow S, Saulnier F. A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. JAMA. 1993;270(24):2957–63. Erratum in: JAMA 1994; 271(17):1321

    Article  CAS  PubMed  Google Scholar 

  5. Sjostrom L, Narbro K, Sjostrom CD, et al. Swedish obese subjects study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.

    Article  PubMed  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. DeMaria EJ, Murr M, Byrne TK, 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):578–82. discussion 583-584

    Article  PubMed  Google Scholar 

  8. Lorente L, Ramón JM, Vidal P, et al. Obesity surgery mortality risk score for the prediction of complications after laparoscopic bariatric surgery. Cir Esp. 2014;92(5):316–23.

    Article  PubMed  Google Scholar 

  9. Salas-Salvado J, Rubio MA, Barbany M, et al. Consenso SEEDO 2007 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervencion terapeutica. Med Clin (Barc). 2007;128(5):184–96.

    Article  Google Scholar 

  10. Campillo-Soto A, Martin-Lorenzo JG, Liron-Ruiz R, et al. Evaluation of the clinical pathway for laparoscopic bariatric surgery. Obes Surg. 2008;18(4):395–400.

    Article  PubMed  Google Scholar 

  11. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    Article  PubMed  PubMed Central  Google Scholar 

  12. 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.

    Article  PubMed  Google Scholar 

  13. Sarela AI, Dexter SP, McMahon MJ. Use of the obesity surgery mortality risk score to predict complications of laparoscopic bariatric surgery. Obes Surg. 2011;21(6):1698–703.

    Article  PubMed  Google Scholar 

  14. Agrawal S. Impact of bariatric fellowship training on perioperative outcomes for laparoscopic Roux-en-Y gastric bypass in the first year as consultant surgeon. Obes Surg. 2011;21(12):1817–21.

    Article  PubMed  Google Scholar 

  15. Pournaras DJ, Jafferbhoy S, Titcomb DR, et al. Three hundred laparoscopic Roux-en-Y gastric bypasses: managing the learning curve in higher risk patients. Obes Surg. 2010;20(3):290–4.

    Article  PubMed  Google Scholar 

  16. Coblijn UK, Lagarde SM, de Raaff CAL, et al. Evaluation of the obesity surgery mortality risk score for the prediction of postoperative complications after primary and revisional laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2016;S1550-7289(16) 30034-X doi:10.1016/j.soard.2016.04.003.

  17. 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.

    Article  PubMed  Google Scholar 

  18. Thomas H, Agrawal S. Systematic review of obesity surgery mortality risk score—preoperative risk stratification in bariatric surgery. Obes Surg. 2012;22(7):1135–40.

    Article  PubMed  Google Scholar 

  19. Arterburn D, Johnson ES, Butler MG, et al. Predicting 90-day mortality after bariatric surgery: an independent, external validation of the OS-MRS prognostic risk score. Surg Obes Relat Dis. 2014;10(5):774–9.

    Article  PubMed  Google Scholar 

  20. Brolin RE, Cody RP, Marcella SW. Differences in open versus laparoscopic gastric bypass mortality risk using the obesity surgery mortality risk score (OS-MRS). Surg Obes Relat Dis. 2015;11(6):1201–6.

    Article  PubMed  Google Scholar 

  21. Flum DR, Belle SH, King WC, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361(5):445–54.

    Article  PubMed  Google Scholar 

  22. Blackstone RP, Cortes MC. Metabolic acuity score: effect on major complications after bariatric surgery. Surg Obes Relat Dis. 2010;6(3):267–73.

    Article  PubMed  Google Scholar 

  23. Gupta P, Franck C, Miller W, et al. Development and validation of a bariatric surgery morbidity risk calculator using the prospective, multicenter NSQIP dataset. J Am Coll Surg. 2011;212(3):301–30.

    Article  PubMed  Google Scholar 

  24. Geubbels N, de Brauw LM, Acherman YI, et al. Risk stratification models: how well do they predict adverse outcomes in a large Dutch bariatric cohort? Obes Surg. 2015;25(12):2290–301.

    Article  PubMed  Google Scholar 

  25. Papasavas PK, Gagne DJ, Kelly J, et al. Laparoscopic Roux-en-Y gastric bypass is a safe and effective operation for the treatment of morbid obesity in patients older than 55 years. Obes Surg. 2004;14(8):1056–61.

    Article  PubMed  Google Scholar 

  26. Moon RC, Kreimer F, Teixeira AF, et al. Morbidity rates and weight loss after Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding in patients older than 60 years old: which procedure to choose? Obes Surg. 2016;26(4):730–6.

    Article  PubMed  Google Scholar 

  27. Dorman RB, Abraham AA, Al-Refaie WB, et al. Bariatric surgery outcomes in the elderly: an ACS NSQIP study. J Gastrointest Surg. 2012;16(1):35–44.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Dr. A. Carrillo for his statistical guidance.

Author information

Authors and Affiliations

  1. Departament of Surgery, Universitary Hospital Jose Mª Morales Meseguer at Murcia, Murcia, Spain

    Maria Luisa García-García, Juan Gervasio Martín-Lorenzo, Ramón Lirón-Ruiz, José Antonio Torralba-Martínez & José Luis Aguayo-Albasini

  2. Departament of Anesthesia, Universitary Hospital Virgen de la Arrixaca at Murcia, Murcia, Spain

    José Antonio García-López

Authors
  1. Maria Luisa García-García
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juan Gervasio Martín-Lorenzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ramón Lirón-Ruiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. José Antonio Torralba-Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. José Antonio García-López
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. José Luis Aguayo-Albasini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria Luisa García-García.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Funding

Article not funded.

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

Does not apply.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

García-García, M.L., Martín-Lorenzo, J.G., Lirón-Ruiz, R. et al. Failure of the Obesity Surgery Mortality Risk Score (OS-MRS) to Predict Postoperative Complications After Bariatric Surgery. A Single-Center Series and Systematic Review. OBES SURG 27, 1423–1429 (2017). https://doi.org/10.1007/s11695-016-2506-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-016-2506-4

Keywords

Search

Navigation