Highlights
- •Longitudinal outcomes of bariatric surgery following the complete transition to MBSAQIP are unclear.
- •This study evaluates the change in bariatric surgery practice before and after the introduction of MBSAQIP from 2007 to 2018.
- •While patients complexity factors have been stable, complications rates have been minimized over the past decade. This was correlated with reduction in length of stay.
- •MBSAQIP era was associated with reduced odds for surgical and medical complications. The program was also associated with early discharge following bariatric surgery.
Abstract
Introduction
This study evaluates the performance of bariatric surgery prior to and after the implementation
of Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).
Methods
The eras prior to (2007–2015) and after (2016–2018) the transition to MBSAQIP were
compared for patients, operations and outcomes using adjusted logistic regression
estimates.
Results
Thirty-day surgical (6%vs.2.9%,p < 0.01) and medical (3.4%vs.1.7%,p < 0.01) complications
rates were reduced over the period 2007 through 2018. Th use of sleeve gastrectomy
has steadily increased from 2010 to 2018 (14%vs.66.6%,p < 0.01). The proportion of
patients who were discharged early continued to rise (9.8%vs.46.9%,p < 0.01) from
2007 to 2018. The MBSAQIP period was associated with reduced odds for 30-day surgical
(OR = 0.86,CI = [0.81–0.91]) and medical (OR = 0.81,CI = [0.75–0.88]) complications.
Implementation of the MBSAQIP was also predictive of early discharge (OR = 1.93,CI = [1.90–2.00]).
Conclusion
The type of bariatric procedure, in addition to trends in morbidity and hospital stays,
gradually changed from 2007 to 2018. Our findings suggest that outcomes of bariatric
operations have improved over the past decade. The MBSAQIP era is associated with
lower rates of complications and greater likelihood of early discharge, independent
of the procedure type.
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Article info
Publication history
Published online: October 04, 2022
Accepted:
September 29,
2022
Received in revised form:
September 19,
2022
Received:
May 2,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.