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PREDICTING MORBIDITY IN ROUX-EN-Y GASTRIC BYPASS PATIENTS: A VERIFIED SCORING TOOL

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

41

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