Highlights
- •The Bariatric Surgical Risk/Benefit Calculator estimates patient-specific 1-year BMI
- •Predicted BMI closely aligned with actual BMI values through 12-months postoperative
- •BMI, weight change, and percent total weight change are estimated for 4 procedures
- •The tool aids in surgical decision-making, communication, and informed consent
Abstract
Background
Data-driven tools can be designed to provide patient-personalized estimates of health
outcomes. Clinical calculators are commonly built to assess risk, but potential benefits
of treatment should be equally considered. The American College of Surgeons Metabolic
and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) sought
to create a risk and benefit calculator for adult patients considering primary metabolic
and bariatric surgery with multiple prediction features: (1) 30-day risk, (2) 1-year
body mass index (BMI) projections, and (3) 1-year co-morbidity remission.
Objective
To assess the performance of the 1-year BMI projections feature of this tool.
Setting
Not-for-profit organization, clinical data registry.
Methods
MBSAQIP data from 596,024 cases across 4.5 years from 882 centers with ∼2.5 million
records through 18 months postoperatively were included. A generalized estimating
equation model was used to estimate BMI over time for 4 primary procedures: laparoscopic
adjustable gastric band, laparoscopic sleeve gastrectomy, laparoscopic Roux-en-Y gastric
bypass, and biliopancreatic diversion with duodenal switch.
Results
The mean absolute error (MAE) in BMI predictions through postoperative month 12 was
1.68 units; overall correlation of actual and predicted BMI was .94. MAE of postoperative
BMI estimates (1–12 mo) was lowest for laparoscopic sleeve gastrectomy (1.64) and
highest for biliopancreatic diversion with duodenal switch (1.99). BMI predictions
at 12 months showed MAE = 2.99 units.
Conclusions
Predicted BMI closely aligned with actual BMI values across the 12-month postoperative
period. The MBSAQIP Bariatric Surgical Risk/Benefit Calculator is publicly available
with the intent to facilitate patient–clinician communication and guide surgical decision
making. This tool can aid in evaluating postoperative risk as well as benefits and
long-term expectations.
Keywords
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Article info
Publication history
Published online: December 17, 2022
Accepted:
December 10,
2022
Received:
July 25,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
