Abstract
Background
Preoperative immobility in general surgery patients has been associated with an increased
risk of postoperative complications. It is unknown if immobility affects bariatric
surgery outcomes.
Objectives
The aim of this study was to determine the impact of immobility on 30-day postoperative
bariatric surgery outcomes.
Setting
This study took place at a university hospital in the United States.
Methods
The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program
2015 data set was queried for primary minimally invasive bariatric procedures. Preoperative
immobility was defined as limited ambulation most or all the time. Logistic regression
analysis was performed to determine if immobile patients are at increased risk (odds
ratio [OR]) for 30-day complications.
Results
There were 148,710 primary minimally invasive bariatric procedures in 2015. Immobile
patients had an increased risk of mortality (OR 4.59, P<.001) and greater operative times, length of stay, reoperation rates, and readmissions.
Immobile patients had a greater risk of multiple complications, including acute renal
failure (OR 6.42, P<.001), pulmonary embolism (OR 2.44, P = .01), cardiac arrest (OR 2.81, P = .05), and septic shock (OR 2.78, P = .02). Regardless of procedure type, immobile patients had a higher incidence of
perioperative morbidity compared with ambulatory patients.
Conclusions
This study is the first to specifically assess the impact of immobility on 30-day
bariatric surgery outcomes. Immobile patients have a significantly increased risk
of morbidity and mortality. This study provides an opportunity for the development
of multiple quality initiatives to improve the safety and perioperative complication
profile for immobile patients undergoing bariatric surgery.
Keywords
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Article info
Publication history
Published online: March 05, 2018
Accepted:
February 27,
2018
Received:
January 6,
2018
Footnotes
☆Presented as a Quickshot oral presentation at the American Society for Metabolic and Bariatric Surgery Obesity Week meeting, Washington D.C., October 2017.
Identification
Copyright
© 2018 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
