Development of a sleeve gastrectomy risk calculator.

Abstract

BACKGROUND:

Laparoscopic sleeve gastrectomy (LSG) is rapidly gaining popularity. Estimating the risk of postoperative adverse events can improve surgical decision-making and informed patient consent. The objective of this study was to develop and validate a risk prediction model for early postoperative morbidity and mortality after LSG.

METHODS:

Cases of primary LSG in the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) data set at year 2012 (n = 5871) and 2011 (n = 3130) were identified to develop and examine the validity of model. The composite primary outcome was defined as presence of any of 14 serious adverse events within the 30-days after LSG. Multiple logistic regression analysis was performed and a risk calculator was created to predict the primary outcome.

RESULTS:

Thirty-day postoperative mortality and composite adverse events rates of 5871 LSG cases were .05% and 2.4%, respectively. Of the 52 examined baseline variables, the final model contained history of congestive heart failure (odds ratio [OR] 6.23; 95% CI 1.25-31.07), chronic steroid use (OR 5.00; 95% CI 2.06-12.15), male sex (OR 1.68; 95% CI 1.03-2.72), diabetes (OR 1.62; 95% CI 1.07-2.48), preoperative serum total bilirubin level (OR 1.57; 95% CI 1.11-2.22), body mass index (OR 1.03; 95% CI 1.01-1.05), and preoperative hematocrit level (OR .95; 95% CI .89-1.00). The risk model was then validated with the 2011 data set and was used to create an online risk calculator with a relatively good accuracy (c-statistic .682).

CONCLUSIONS:

This risk assessment scoring system, which specifically estimates serious adverse events after LSG, can contribute to surgical decision-making, informed patient consent, and prediction of surgical risk for patients and referring physicians.

• Authors: Ali Aminian, Stacy A Brethauer, Maryam Sharafkhah, Philip R Schauer
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) 2015 Jul-Aug Vol. 11 Issue 4 Pg. 758-64 ISSN: 1878-7533 [Electronic] United States
• PMID: 26117166 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2015. Published by Elsevier Inc.

Topics

• Adult
• Female
• Gastrectomy (methods)
• Humans
• Laparoscopy (methods)
• Male
• Morbidity (trends)
• Obesity, Morbid (surgery)
• Odds Ratio
• Outcome Assessment, Health Care
• Postoperative Complications (epidemiology)
• Reproducibility of Results
• Retrospective Studies
• Risk Assessment (methods)
• Risk Factors
• Survival Rate (trends)
• Treatment Outcome
• United States (epidemiology)