Use of the Obesity Surgery Mortality Risk Score to Predict Complications of Laparoscopic Bariatric Surgery

• Published in: Obesity surgery 2011-11, Vol.21 (11), p.1698-1703
• Main Authors: Sarela, Abeezar I., Dexter, Simon P. L., McMahon, Michael J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Clinical Research; Female; Gastric Bypass - adverse effects; Gastric Bypass - methods; Gastric Bypass - mortality; Gastrointestinal surgery; Humans; Laparoscopy; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Obesity; Obesity - surgery; Postoperative Complications - epidemiology; Prognosis; Risk Assessment; Surgery; Surgical outcomes; Young Adult
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-011-0379-0

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/m 2 (30–84 kg/m 2 ); 37% had BMI ≥50 kg/m 2 . 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.