New risk/benefit calculator can predict possible outcomes for metabolic and bariatric surgery patients

Aug. 23, 2019
Tool predicts a patient’s possibility of postoperative remission at one year for up to five different weight-related comorbidities

A new surgical risk/benefit calculator provides metabolic and bariatric surgeons and patients with accurate, patient-specific information to guide surgical decision making and informed consent is being released by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).

“This calculator is extremely meaningful in that it uses millions of cases within the unique clinical registry data from the MBSAQIP to address three important areas,” said Clifford Y. Ko, MD, MS, MSHS, FACS, Director of the American College of Surgeons (ACS) Division of Research and Optimal Patient Care, in a statement. “First it predicts rates of untoward events; second, it predicts weight loss; and third, and possibly most important, it predicts rates of disease resolution, including such things as diabetes, hypertension, sleep apnea, and others.”

The Bariatric Surgical Risk/Benefit Calculator was built using data collected from more than 775,000 operations from 925 centers participating in MBSAQIP from January 1, 2013, through June 30, 2018. For 30-day outcomes, the calculator uses 20 patient predictors, such as age, American Society of Anesthesiologists Physical Status classification, and preoperative body mass index (BMI) to predict the likelihood that patients will experience any of nine different outcomes within the first 30 days after an operation. Examples of these outcomes include surgical site infections, unplanned reoperations, and death.

The calculator can predict the patient’s BMI, weight, and total weight change percentage trajectories up to one year after an operative procedure. To assist with patients’ understanding of the predictions, the calculator provides a summary report designed for patients to share the information with their families and other multidisciplinary team members involved in their care.

“This tool will allow for a patient-centered approach to risk assessment, procedure selection, and has the additional significant advantage of determining and maintaining progress after surgery with weight loss and comorbidity improvement milestones for the critical first post-operative year,” said John Magaña Morton, MD, MPH, MHA, FACS, FASMBS, ABOM, Vice Chair, Quality, and Division Chief, Bariatric and Minimally Invasive Surgery, Yale University School of Medicine. “With over 700,000 cases and 900 hospitals participating over five years, this valuable instrument has the potential to deliver precision care to over 250,000 patients annually, said Morton, Chair of the ACS Committee for Metabolic and Bariatric Surgery (CMBS).

The calculator was introduced at the 2019 ACS Quality and Safety Conference in Washington, DC, and will be available in late August both on the ACS website for all metabolic and bariatric surgery centers to use as well as the data registry portal for MBSAQIP-accredited centers.