Five-Year Analysis of the MBSAQIP Database: Are We Getting Better?

Abstract

BACKGROUND: The MBSAQIP has been used to evaluate risk and create risk models. Previous studies have determined what complications matter most. STUDY DESIGN: This study was a registry-based analysis of patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) between January 1, 2015, and December 31, 2019, at centers participating in MBSAQIP. Cases were identified using Current Procedural Terminology. Patients less than 18 years old were excluded. A chi-square test was used to assess differences in the prevalence of complications and effects across years. Using a multivariable Poisson regression model with a link log and robust estimation, prevalence ratio estimates and 95% CI were obtained. RESULTS: A total of 690,770 observations met the inclusion criteria. Mean (SD) age was 44.5 (±12.0) years, and mean (SD) BMI was 45.2 kg/m2 (±7.9). SG cases accounted for 73.45% of all observations. There was a significant relative reduction in readmissions, end-organ dysfunction, and all-cause mortality from 2015 to 2019 in the SG subgroup. There were also noticeable reductions in 30-day readmission, ICU admission, and end-organ dysfunction in the RYGB subgroup. For complications, bleeding, postoperative pneumonia, and stroke were significantly decreased in the RYGB subgroup, but only bleeding was significantly decreased in the SG subgroup during the 5-year study period. CONCLUSIONS: There has been a continuous improvement in several (but not all) outcomes through the years that the MBSAQIP has been collecting data. Different outcomes were reduced between the SG and RYGB subgroups, and the decrease in all-cause mortality was only noted in the SG subgroup.

Results from the Scandinavian Obesity Surgery Registry: A narrative review

“…So is also the unplanned return to theater, intensive care unit (ICU) care, and readmission to hospital 97 . Like SOReg, the American Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) containing 690,770 observations (mean BMI 45.2 kg/m 2 , age 44.5 years) reports a continuous improvement in several outcomes, especially perioperative complications and readmissions 98 …”

Common postbariatric surgery emergencies for the acute care surgeon: What you need to know

“…In addition, there have been major evolutions in the commonly performed bariatric operations and their numerous variants, as well as the shift to minimally invasive techniques as the standard approach for most patients 5–7 . There are now 862 bariatric surgery programs in the United States accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, with joint oversight from the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery 8 . Not unexpectedly, the high and continually increasing numbers of patients undergoing bariatric surgery have translated to increasing volumes of patients presenting with urgent or emergent surgical complications that are related to their primary bariatric surgery or that are complicated by their existing bariatric anatomy 9–13 …”

“…[5][6][7] There are now 862 bariatric surgery programs in the United States accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, with joint oversight from the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery. 8 Not unexpectedly, the high and continually increasing numbers of patients undergoing bariatric surgery have translated to increasing volumes of patients presenting with urgent or emergent surgical complications that are related to their primary bariatric surgery or that are complicated by their existing bariatric anatomy. [9][10][11][12][13] Over this same period, there has been a major shift in the coverage of emergency general surgery as it has become integrated (along with trauma and surgical critical care) into the specialty of acute care surgery (ACS) at most major academic and trauma centers.…”