Background

Obesity is an independent risk factor for postoperative complications. There is little data analyzing the complications of bariatric surgery by BMI status. The purpose of this study is to perform a review of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant Use Data File (PUF) to analyze the complications and readmission rates of bariatric surgical procedures between BMI classes.

Methods

The 2020 and 2021 MBSAQIP PUFs were obtained for retrospective review. Cases were selected for inclusion by CPT codes for sleeve gastrectomy (43775) and Roux-en-Y gastric bypass (43644) and preoperative BMI>30. Postop occurrences increased with each BMI class, and were found to notably increase at BMI>50 which was used to distinguish cohorts for analysis of specific complications. Pearson’s Chi-square tests were performed on reported data between BMI>50 and BMI<50.

Results

A total of 317,841 cases from the 2020-2021 MBSAQIP PUFs were included. Postoperative occurrences were significantly higher in patients with BMI>50 when compared to BMI<50. Patients with BMI>50 were found to have significantly higher mortality rates as well as acute renal failure, PE, SSI, and UTI. ED visits and readmission rates were also significantly higher in the BMI>50 cohort however interventions were similar.

Conclusions

Obesity is a well-known risk factor for surgical complications, especially in bariatric surgery as this is the indication for the procedure. This study reports granular data on specific complications rates by BMI and, to our knowledge, is the first to show that overall complications and readmissions in bariatric surgery increase with BMI, specifically with BMI>50.