Impact of Functional Status on 30-day Resource Utilization and Organ System Complications Following Bariatric Surgery

University of Virginia65,627 enrolled

Overview

The goal of this observational study is to assess the effect of functional status on bariatric surgical thirty-day outcomes. The main questions it aims to answer are: * Is functional status associated with higher incidence of 30-day unplanned resource utilization? * Is functional status associated with higher incidences of secondary adverse events? Participants will be sampled from the 2015-2019 American College of Surgeons National Surgical Quality Improvement Program

Study Type

OBSERVATIONAL

Enrollment

65,627

Conditions

Dependence Perioperative/Postoperative Complications Frailty

Interventions

Bariatric surgeryPROCEDURE

Current Procedural Terminology (CPT) codes: 43644, 43645, 43770, 43775, 43842, 43843, 43845, 43846, 43847.

General anestheticDRUG

Cases were required to have a documented "general anesthesia" anesthetic technique. Administered drugs were otherwise indeterminate under the current study design (observational study of a deidentified database).

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Current Procedural Terminology (CPT) codes: 43644, 43645, 43770, 43775, 43842, 43843, 43845, 43846, 43847 * Elective, non-emergent cases * "General surgery" surgical specialty * "General anesthesia" anesthetic technique Exclusion Criteria: * Documented concurrent or other procedures * Patients admitted to the hospital for greater than one day preceding surgery * Acute kidney injury (preoperative) * End-stage renal disease (preoperative) * Metastatic disease (preoperative) * Wound infection (preoperative) * Sepsis (preoperative)

Outcomes

Primary Outcomes

Unplanned resource utilization (composite)

A composite binary outcome comprising unplanned readmission, return to the operating room, or prolonged (≥ 30 day) length of stay.

Time frame: 30 days

Secondary Outcomes

Composite organ system complications

Cardiac complications included cardiac arrest and myocardial infarction. The only neurologic complication that was captured was stroke/cerebrovascular accident. Respiratory complications included reintubation, prolonged ventilatory wean, and pneumonia. Hematologic/infectious complications included superficial surgical site infection (SSI), deep incisional SSI, organ space SSI, wound dehiscence, bleeding, sepsis, septic shock, deep venous thrombosis, and pulmonary embolism. Renal complications included progressive renal insufficiency and acute kidney injury.

Time frame: 30 days

Mortality

Time frame: 30 days