Ann M Defnet, MD, Christine Ren Fielding, MD, George Fielding, MD, Bradley Schwack, MD, Allison Youn, RN, CCRC, MA, G Craig Wood, MS, Andrea Bedrosian, MD. NYU Langone Medical Center
Introduction: We aimed to create a morbidity prediction score for patients undergoing RYGB using MBSA-QIP data.
Methods and Procedures: We retrospectively analyzed all RYGB cases in MBSA-QIP during 2015, and identified factors associated with 30-day complications using chi-squared analysis. Multiple logistic regression identified pre-operative factors independently associated with 30-day complication to develop a prediction score, verified using a Cochran Armitage trend test.
Results: For 42,849 procedures, there were 3034 (7.1%) with any 30-day complication. Preoperative patient characteristics independently associated with increased risk of morbidity are shown in Table 1. A scoring algorithm was formulated by assigning points based on strength of the odds ratio (Table 1), with the final score a summation of points accrued. The rate of any 30-day complication was evaluated across the range of scores (Table 2). Higher scores were associated with a higher rate of morbidity (p<0.0001 for each).
Table 1: Patient characteristics independently associated with 30-day complications
| Parameter | OR | 95% CI | p-value | Number of Points |
| Female sex | 1.21 | [1.10, 1.34] | 0.0001 | 1 |
| Black race | 1.31 | [1.11, 1.45] | <0.0001 | 1 |
| History of severe COPD | 1.29 | [1.03,1.62] | 0.028 | 1 |
| Oxygen dependence | 1.42 | [1.02, 1.96] | 0.036 | 2 |
| History of PE | 1.89 | [1.46, 2.45] | <0.0001 | 4 |
| GERD requiring medication | 1.33 | [1.23, 1.43] | <0.0001 | 1 |
| Previous PCI/PTCA | 1.42 | [1.15, 1.75] | 0.0010 | 2 |
| Use of mobility device | 1.35 | [1.23, 1.43] | 0.0057 | 1 |
| Previous obesity surgery | 1.43 | [1.27, 1.61] | <0.0001 | 2 |
| Therapeutic anticoagulation | 1.53 | [1,24, 1.89] | <0.0001 | 2 |
Table 2: 30-day complication rate by complication risk score
| Score | Complication rate |
| 0 | 5.3% |
| 1 | 5.7% |
| 2 | 7.8% |
| 3 | 8.6% |
| 4 | 10.8% |
| 5 | 12.0% |
| 6 | 13.4% |
| 7+ | 21.5% |
Conclusion: We created and verified a morbidity prediction score for patients undergoing RYGB based on MBSA-QIP data.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87499
Program Number: P644
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster