A new risk calculator can predict the risk of postoperative complications occurring for individual bariatric surgery patients, according to a study published in the March issue of the Journal of the American College of Surgeons. The risk calculator will help in surgical decision-making and will help patients better understand what they can expect during recovery in order to prepare for a bariatric operation.
The study authors developed the risk calculator based on data from the American College of Surgeons' National Surgical Quality Improvement Program (ACS NSQIP), which collected pre-operative through 30-day follow up data on patients undergoing an operation at 183 (year 2007) and 211 (year 2008) participant academic and community hospitals. Bariatric surgical procedures have proven successful in treating obesity and particularly in addressing related co-morbidities such as diabetes, hypertension, and sleep apnea. While the epidemic of obesity continues to plague America, its highly effective surgical therapy is underutilized due to concerns for surgical risk among patients and referring physicians.
The 2007 ACS NSQIP data used to develop the risk calculator included 11,023 patients, all undergoing bariatric procedures for morbid obesity. The 2008 dataset was used for validation. Recent heart attack or angina, stroke, high blood pressure, use of blood thinners, limited ability to perform basic activities of daily living, higher weight and the type of bariatric procedure, were found to be associated with increased risk.
"Patients who are morbidly obese already face great health risks and bariatric surgery can be a life-saving option," said Prateek K. Gupta, MD, general surgery resident at Creighton University Medical Center, Omaha, NE, and the study's lead author. "The risk calculator will aid patients in better preparing for their operation by understanding the true risks and benefits of a bariatric procedure. It will also assist the surgeon and patient in choosing the type of bariatric procedure. While the risk of death after bariatric operations is extremely low, obese patients are at an increased risk of postoperative complications, making the risk calculator particularly useful."
Available online here for free download, this new risk calculator allows surgeons to accurately model and predict exact patient postoperative morbidities, which include wound infections, sepsis, heart attack, kidney failure, lung failure, and other conditions.
"Surgical decision making and informed consent rely on accurate information about surgical risks," stated R. Armour Forse, MD, FACS, a bariatric surgeon at Creighton University Medical Center and study co-author. "Making sure our patients understand their procedure and any associated risks involved, is an extremely important, but sometimes difficult conversation. Using this tool correctly should help patients feel more at ease with the process and potential outcomes knowing that their physician is being open with them."
- Prateek K. Gupta, Christopher Franck, Weldon J. Miller, Himani Gupta, R. Armour Forse. Development and Validation of a Bariatric Surgery Morbidity Risk Calculator Using the Prospective, Multicenter NSQIP Dataset. Journal of the American College of Surgeons, 2011; 212 (3): 301 DOI: 10.1016/j.jamcollsurg.2010.11.003
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