Faculty Collaboration Database

Preoperative immobility significantly impacts the risk of postoperative complications in bariatric surgery patients. Surg Obes Relat Dis 2018 Jun;14(6):842-848

Date

03/31/2018

Pubmed ID

29599072

DOI

10.1016/j.soard.2018.02.025

Scopus ID

2-s2.0-85044583677 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

BACKGROUND: Preoperative immobility in general surgery patients has been associated with an increased risk of postoperative complications. It is unknown if immobility affects bariatric surgery outcomes.

OBJECTIVES: The aim of this study was to determine the impact of immobility on 30-day postoperative bariatric surgery outcomes.

SETTING: This study took place at a university hospital 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. Preoperative immobility was defined as limited ambulation most or all the time. Logistic regression analysis was performed to determine if immobile patients are at increased risk (odds ratio [OR]) for 30-day complications.

RESULTS: There were 148,710 primary minimally invasive bariatric procedures in 2015. Immobile patients had an increased risk of mortality (OR 4.59, P<.001) and greater operative times, length of stay, reoperation rates, and readmissions. Immobile patients had a greater risk of multiple complications, including acute renal failure (OR 6.42, P<.001), pulmonary embolism (OR 2.44, P = .01), cardiac arrest (OR 2.81, P = .05), and septic shock (OR 2.78, P = .02). Regardless of procedure type, immobile patients had a higher incidence of perioperative morbidity compared with ambulatory patients.

CONCLUSIONS: This study is the first to specifically assess the impact of immobility on 30-day bariatric surgery outcomes. Immobile patients have a significantly increased risk of morbidity and mortality. This study provides an opportunity for the development of multiple quality initiatives to improve the safety and perioperative complication profile for immobile patients undergoing bariatric surgery.

Author List

Higgins RM, Helm M, Gould JC, Kindel TL

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

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

Aged
Bariatric Surgery
Body Mass Index
Female
Humans
Immobilization
Laparoscopy
Male
Middle Aged
Obesity, Morbid
Postoperative Complications
Preoperative Period
Risk Factors