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Implementation of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program and outcomes of bariatric surgery

  • Ahmed M. Al-Mazrou
    Correspondence
    Corresponding author. Division of GI Metabolic and Bariatric Surgery, Department of Surgery, NewYork-Presbyterian Hospital / Weill Cornell Medicine, 525 East 68th Street Box 294, New York, NY, 10065, United States.
    Affiliations
    Division of GI Metabolic and Bariatric Surgery, Department of Surgery, NewYork-Presbyterian Hospital / Weill Cornell Medicine, 525 East 68th Street Box 294, New York, NY, 10065, United States

    Division of Bariatric Surgery, Department of Surgery, King Saud University, College of Medicine, Riyadh, Saudi Arabia
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  • Omar Bellorin
    Affiliations
    Division of GI Metabolic and Bariatric Surgery, Department of Surgery, NewYork-Presbyterian Hospital / Weill Cornell Medicine, 525 East 68th Street Box 294, New York, NY, 10065, United States
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  • Gregory Dakin
    Affiliations
    Division of GI Metabolic and Bariatric Surgery, Department of Surgery, NewYork-Presbyterian Hospital / Weill Cornell Medicine, 525 East 68th Street Box 294, New York, NY, 10065, United States
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  • Alfons Pomp
    Affiliations
    Division of GI Metabolic and Bariatric Surgery, Department of Surgery, NewYork-Presbyterian Hospital / Weill Cornell Medicine, 525 East 68th Street Box 294, New York, NY, 10065, United States
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  • Mark Aaron Unruh
    Affiliations
    Department of Population Health Sciences, Weill Cornell Medical College, 402 E 67th St, New York, NY, 10065, United States
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  • Cheguevara Afaneh
    Affiliations
    Division of GI Metabolic and Bariatric Surgery, Department of Surgery, NewYork-Presbyterian Hospital / Weill Cornell Medicine, 525 East 68th Street Box 294, New York, NY, 10065, United States
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Published:October 04, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.09.059

      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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