June 26, 2009

Scoring reduces bariatric complications

A scoring system that rates a bariatric surgery patient's risk of complications can reduce post-surgical complications by 65 percent, U.S. researchers said.

The scoring system that rates a bariatric surgery patient's risk of complications on a scale of 1 to 4 can also reduce hospital re-admission rates by more than 80 percent.

Researchers from Arizona devised a Metabolic Acuity Score that places surgery patients into one of four groups based on risk factors including the severity of their morbid obesity and obesity-related diseases such as type 2 diabetes, sleep apnea, heart disease and their psychological health.

The study found that after the Metabolic Acuity Score had been implemented, 30-day post-surgery complication rates dropped by 65 percent, from 17.9 percent to 6.2 percent. Thirty-day hospital re-admissions fell 81 percent from 7.4 percent to 1.4 percent. On average, patients lost almost 80 percent of their excess weight within one year and the mortality rate was zero.

More than 2,400 laparoscopic gastric bypass -- 1,821 -- and laparoscopic gastric band --595 -- patients were evaluated for incidence of major complications, mortality, length of hospital stay, readmission and re-operations.

Lead author Dr. Robin Blackstone of Scottsdale Bariatric Center in Arizona said that using the Metabolic Acuity Score improves the safety profile of bariatric surgery to levels approaching routine gallbladder surgery, even for high risk patients.

The study was presented at the 26th annual meeting of the American Society for Metabolic & Bariatric Surgery in Dallas.