The Impact of Metabolic and Bariatric Surgeon Status on Outcomes After Bariatric Surgery: a Retrospective Cohort Study Using the MBSAQIP Database

Purpose Differences between complication rates of bariatric surgeries performed by general surgeons (GS) versus those performed by metabolic and bariatric surgeons (MBS) are poorly understood. Methods We analyzed the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSA...

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Bibliographic Details
Published in:Obesity surgery 2022-06, Vol.32 (6), p.1944-1953
Main Authors: Purich, Kieran, Mocanu, Valentin, Joy, Joshua, Verhoeff, Kevin, Dang, Jerry, Switzer, Noah J., Birch, Daniel W., Karmali, Shahzeer
Format: Article
Language:English
Subjects:
Accreditation
Adult
Bariatric Surgery - adverse effects
Bariatric Surgery - methods
Cohort analysis
Gastrectomy - methods
Gastric Bypass - methods
Gastrointestinal surgery
Humans
Laparoscopy
Medicine
Medicine & Public Health
Metabolism
Mortality
Obesity, Morbid - surgery
Original Contributions
Postoperative Complications - epidemiology
Postoperative Complications - surgery
Quality Improvement
Retrospective Studies
Surgeons
Surgery
Treatment Outcome
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Summary:Purpose Differences between complication rates of bariatric surgeries performed by general surgeons (GS) versus those performed by metabolic and bariatric surgeons (MBS) are poorly understood. Methods We analyzed the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database focusing on RYGB and SG procedures between 2016 and 2019. Our primary objective was to evaluate trends in the number of bariatric procedures performed by GS and MBS. Secondary objectives were assessing for differences in 30-day mortality and the incidence of serious complications. Differences between groups were evaluated by chi-squared analysis for categorical data and ANOVA tests for continuous data. A multivariable logistic regression was performed to determine the influence of subspecialized training on the incidence of serious complications and 30 day mortality. Results A total of 622,079 patients were analyzed, 15,485 were operated on by GS (2.5%, mean age 44.7 years, mean BMI 45.2 kg/m 2 ), while 606,594 procedures were performed by MBS (97.5%, mean age 44.4 years, mean BMI 45.2 kg/m 2 ). The proportion of procedures being completed by the GS group decreased from n =4662, 3.2% in 2016, to n =3414, 2.1% in 2019. After adjusting for comorbidities, MBS patients did not have differences in death at 30 days (OR 1.26 [0.67–2.38], p =0.467) or serious complications (OR 0.97 [0.89–1.06], p =0.554). Conclusion The majority of bariatric procedures are being completed by MBS with the proportion completed by GS decreasing. We found no difference in the number of serious complications and 30-day mortality rates across the MBS and GS groups. Graphical abstract
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-022-06028-6