The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program bariatric surgical risk/benefit calculator: 30-day risk.
Surg Obes Relat Dis
; 17(6): 1117-1124, 2021 Jun.
Article
en En
| MEDLINE
| ID: mdl-33773930
ABSTRACT
BACKGROUND:
There is increasing demand for data-driven tools that provide accurate and clearly communicated patient-specific information. These can aid discussions between practitioners and patients, promote shared decision-making, and enhance informed consent. The American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) sought to create a risk calculator for adult patients considering primary metabolic and bariatric surgery, with multiple prediction features (1) 30-day risk; (2) 1-year body mass index projections; and (3) 1-year co-morbidity remission.OBJECTIVES:
To evaluate the 30-day risk estimation feature of this tool.SETTING:
Not-for-profit organization, international bariatric surgery clinical data registry.METHODS:
MBSAQIP data across 5.5 years, 925 hospitals, and 775,291 cases were used to develop the 30-day risk feature. Logistic regression models were employed to estimate postoperative risks for 9 outcomes across 4 procedures laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, laparoscopic adjustable gastric band, and biliopancreatic diversion with duodenal switch.RESULTS:
The tool showed good discrimination for mortality and surgical site infection models (c-statistics, .80 and .70, respectively), and was slightly less accurate for the 7 other complications (.62-.69). Graphical representations showed excellent calibration for all 9 outcomes.CONCLUSIONS:
Overall, the 30-day risk models were accurate and well calibrated, with acceptable discrimination. The MBSAQIP bariatric surgical risk/benefit calculator is publicly available, with the intent to be integrated into healthcare practice to guide bariatric surgical decision-making and care planning, and to enhance communication between patients and their surgical care team.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Obesidad Mórbida
/
Derivación Gástrica
/
Cirugía Bariátrica
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Surg Obes Relat Dis
Asunto de la revista:
METABOLISMO
Año:
2021
Tipo del documento:
Article