Comparison of short-term outcomes following Roux-en-Y gastric bypass in male and female patients using the MBSAQIP database.
Biologic sex
MBSAQIP
Roux-en-y gastric bypass
Journal
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
06
08
2019
revised:
03
04
2020
accepted:
24
04
2020
pubmed:
26
6
2020
medline:
28
4
2021
entrez:
26
6
2020
Statut:
ppublish
Résumé
Male sex has long been identified as a risk factor for adverse outcomes, including mortality, after Roux-en-Y gastric bypass (RYGB). The objective of this study was to compare short-term outcomes of patients undergoing laparoscopic RYGB based on biologic sex. Geisinger Medical Center, Danville, PA. Patients undergoing RYGB in the 2015, 2016, and 2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database were propensity matched 1:1 to compare 30-day outcomes between male and female sex. A total 47,906 patients were included (23,953 men/23,953 women). The overall complication rate was higher in female patients (11.5% versus 10.2%; P < .001) with no difference in mortality related to RYGB at 30 days. No significant differences were seen between sexes for organ space surgical site infection or septic shock. Women had significantly more superficial surgical site infections (P = .002), urinary tract infections (P < .001), readmissions (P < .001), and reinterventions (P < .001). Men had significantly more episodes of unplanned intubation (P = .008), extended ventilator use (P = .01), progressive renal insufficiency (P = .01), acute renal failure (P = .008), cardiac arrest (P = .005), intensive care unit admission (P < .001), all-cause 30-day mortality (P = .038), and inpatient mortality rate (P < .001). Male sex has been identified as a risk factor for adverse events and mortality after RYGB in several risk models. This study demonstrates an overall increased risk of both all-cause mortality and inpatient mortality. The study, however, did not demonstrate a difference in bariatric-related mortality. The prevalence of both major and minor complications was mixed between sexes, while women had a higher overall complication rate after RYGB. The abundance of data available within the MBSAQIP Participant Use Data File facilitates the creation of tools like risk models for bariatric surgery, such as the MBSAQIP Risk calculator.
Sections du résumé
BACKGROUND
BACKGROUND
Male sex has long been identified as a risk factor for adverse outcomes, including mortality, after Roux-en-Y gastric bypass (RYGB).
OBJECTIVES
OBJECTIVE
The objective of this study was to compare short-term outcomes of patients undergoing laparoscopic RYGB based on biologic sex.
SETTING
METHODS
Geisinger Medical Center, Danville, PA.
METHODS
METHODS
Patients undergoing RYGB in the 2015, 2016, and 2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database were propensity matched 1:1 to compare 30-day outcomes between male and female sex.
RESULTS
RESULTS
A total 47,906 patients were included (23,953 men/23,953 women). The overall complication rate was higher in female patients (11.5% versus 10.2%; P < .001) with no difference in mortality related to RYGB at 30 days. No significant differences were seen between sexes for organ space surgical site infection or septic shock. Women had significantly more superficial surgical site infections (P = .002), urinary tract infections (P < .001), readmissions (P < .001), and reinterventions (P < .001). Men had significantly more episodes of unplanned intubation (P = .008), extended ventilator use (P = .01), progressive renal insufficiency (P = .01), acute renal failure (P = .008), cardiac arrest (P = .005), intensive care unit admission (P < .001), all-cause 30-day mortality (P = .038), and inpatient mortality rate (P < .001).
CONCLUSIONS
CONCLUSIONS
Male sex has been identified as a risk factor for adverse events and mortality after RYGB in several risk models. This study demonstrates an overall increased risk of both all-cause mortality and inpatient mortality. The study, however, did not demonstrate a difference in bariatric-related mortality. The prevalence of both major and minor complications was mixed between sexes, while women had a higher overall complication rate after RYGB. The abundance of data available within the MBSAQIP Participant Use Data File facilitates the creation of tools like risk models for bariatric surgery, such as the MBSAQIP Risk calculator.
Identifiants
pubmed: 32580922
pii: S1550-7289(20)30250-1
doi: 10.1016/j.soard.2020.04.045
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1236-1241Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.