Faculty Collaboration Database

Preoperative functional health status is a predictor of short-term postoperative morbidity and mortality after bariatric surgery. Surg Obes Relat Dis 2019 Apr;15(4):608-614

Date

03/10/2019

Pubmed ID

30850305

DOI

10.1016/j.soard.2019.02.004

Scopus ID

2-s2.0-85062370891 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

BACKGROUND: Functional health status (FHS) is the ability to perform activities of daily living without caregiver assistance.

OBJECTIVES: The primary aim of this study was to determine the impact of impaired preoperative FHS on morbidity and mortality within 30 days of bariatric surgery.

SETTING: Academic medical center in the United States.

METHODS: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 data set was queried for primary minimally invasive bariatric procedures. The demographic characteristics and perioperative details of patients who were functionally independent were compared with patients with impaired FHS. Multivariable logistic regression analysis was performed to determine the odds of developing a perioperative complication or death for patients with impaired functional health.

RESULTS: Of patients, 1515 (1.0%) were reported as having impaired FHS and 147,195 patients (99.0%) were independent before surgery. Patients with impaired FHS experienced significantly longer length of hospital stays (2.4 versus 1.8 d; P < .0001), a higher morbidity (adjusted odds ratio 1.5; P <0.0001), and higher mortality (adjusted odds ratio 2.1; P < .0001). Impaired FHS resulted in significantly increased rate of unplanned admissions to the intensive care unit, interventions, reoperations, and readmissions within 30 days of surgery.

CONCLUSIONS: Patients with impaired FHS preoperatively have a significantly increased risk of short-term morbidity and mortality after bariatric surgery. The results of this study highlight the importance of establishing quality initiatives focused on improving short-term outcomes for patients with impaired functional health status.

Author List

Lak KL, Helm MC, Higgins RM, Kindel TL, Gould JC

Authors

Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Rana Higgins MD Associate Professor in the Surgery department at Medical College of Wisconsin
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
Kathleen L. Lak MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Bariatric Surgery
Female
Health Status
Humans
Male
Middle Aged
Obesity
Patient Readmission
Postoperative Complications
Reoperation
Retrospective Studies
Treatment Outcome