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
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