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. 2019 Feb;15(2):253-260.
doi: 10.1016/j.soard.2018.12.006. Epub 2018 Dec 6.

How safe is bariatric surgery in patients with class I obesity (body mass index 30-35 kg/m2)?

Xiaoxi Feng  1 , Amin Andalib  2 , Stacy A Brethauer  1 , Philip R Schauer  1 , Ali Aminian  3
Affiliations

How safe is bariatric surgery in patients with class I obesity (body mass index 30-35 kg/m2)?

Xiaoxi Feng et al. Surg Obes Relat Dis. 2019 Feb.

Abstract

Background: The safety profile of bariatric surgery in patients with class I obesity, or body mass index ≥30 and <35 kg/m2, is a matter of concern among patients and physicians.

Objective: To assess the safety profile of bariatric surgery in patients with class I obesity.

Setting: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) data set.

Methods: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 to 2016 data sets were queried for class I obesity patients who underwent primary bariatric procedures. The 30-day postoperative safety profile, predictors of adverse events, and comparison between Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) were studied.

Results: A total of 8628 cases with a mean preoperative body mass index of 33.7 ± 1.1 kg/m2 were analyzed: 1838 (21.3%) underwent RYGB, 6243 (72.4%) underwent SG, 530 (6.1%) underwent gastric banding, and 17 (.2%) underwent duodenal switch; 33.9% had diabetes and 75% had hypertension. The composite morbidity rate (defined as presence of any of 24 postoperative adverse events) for the entire cohort was 3.8%, and the serious morbidity rate (presence of any of 9 serious complications) was .7%. The 30-day mortality rate was .05% (4 cases). Presence of chronic kidney disease was found to be associated with higher composite and serious morbidity (composite morbidity: odds ratio 5.1, 95% confidence interval 2.22-11.71; serious morbidity: odds ratio 5.66, 95% confidence interval 1.52-21.14). SG patients had significantly better short-term safety outcomes than RYGB patients.

Conclusion: Findings from this study, the largest series to date, indicate that bariatric surgery is safe in patients with class I obesity, with very low risk of morbidity and mortality.

Keywords: Bariatric surgery; Body mass index; Complication; Diabetes; Gastric bypass; MBSAQIP; Metabolic surgery; Morbidity; Mortality; Obesity; Overweight; Safety; Sleeve gastrectomy.

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