Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;33(2):443-452.
doi: 10.1007/s11695-022-06423-z. Epub 2022 Dec 21.

Characterization of Pre- and Postpandemic 30-Day Follow-Up After Elective Bariatric Surgery: a Retrospective MBSAQIP Analysis of 834,646 Patients

Hillary A Wilson #  1 , Valentin Mocanu #  2 , Cheynne McLean #  2 , Daniel W Birch #  2 , Shahzeer Karmali #  2 , Noah J Switzer #  2
Affiliations

Characterization of Pre- and Postpandemic 30-Day Follow-Up After Elective Bariatric Surgery: a Retrospective MBSAQIP Analysis of 834,646 Patients

Hillary A Wilson et al. Obes Surg. 2023 Feb.

Abstract

Background: Effects of the COVID-19 pandemic on rates of early postoperative follow-up after bariatric surgery are poorly understood. Our study characterizes 30-day follow-up after bariatric surgery prior to COVID-19 (years 2015-2019) and during the pandemic of COVID-19 (year 2020) and evaluates general predictive factors of short-term follow-up.

Methods: Data was extracted from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) data registry from 2015 to 2020. Cohorts were divided into pre-pandemic and pandemic years and patients with and without 30-day follow-up. Multivariable logistic regression analysis was used to identify general factors independently predictive of 30-day follow-up. The primary aim was to evaluate the impact of the COVID-19 pandemic on short-term 30-day follow-up adherence. A secondary outcome was to characterize general short-term postoperative 30-day follow-up associated with elective bariatric surgery and identify independent predictors of 30-day follow-up among bariatric surgery patients using multivariable logistic regression analysis.

Results: A total of 834,646 patients were identified. Follow-up rates significantly increased in the COVID era in 2020 (p < 0.0001). Patients who achieved 30-day follow-up were older and had an increased burden of medical comorbidities, including non-insulin and insulin-dependent diabetes mellitus, hypertension, dyslipidemia, as well as increased BMI compared to patients lacking follow-up. The cohort with successful 30-day follow-up was more likely to receive gastric bypass and had increased rates of metabolic comorbidities. After adjusting for comorbidities, the greatest independent predictors of follow-up were the 2020 COVID-19 era year, Asian race, black race, and gastroesophageal reflux disease.

Conclusions: After adjusting for comorbidities, the 2020 COVID-19 era year was one of the greatest predictors of follow-up after bariatric surgery. Postoperative follow-up rates after elective bariatric surgery are excellent at > 95% and increased during the 2020 COVID-19 era year. Several independent predictors of follow-up were identified which may help in development of strategies aimed to mitigate lack of postoperative follow-up.

Keywords: 30-day; Bariatric surgery; COVID-19; Early; Obesity; Pandemic; Postoperative follow-up; Predictors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Summary of key predictors of 30-day postoperative follow-up including operative year, racial status, body mass index, sex, and smoking
Fig. 2
Fig. 2
Trends in follow-up by postoperative year for bariatric surgery patients who underwent either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) procedures between 2015 and 2020
See this image and copyright information in PMC

References

    1. Smith MD, Patterson E, Wahed AS, Belle SH, Berk PD, Courcoulas AP, Dakin GF, Flum DR, Machado L, Mitchell JE, Pender J, Pomp A, Pories W, Ramanathan R, Schrope B, Staten M, Ude A, Wolfe BM. Thirty-day mortality after bariatric surgery: independently adjudicated causes of death in the longitudinal assessment of bariatric surgery. Obes Surg. 2011;21:1687–1692. doi: 10.1007/s11695-011-0497-8. - DOI - PMC - PubMed
    1. Keren D, Matter I, Rainis T, Lavy A. Getting the most from the sleeve: the importance of post-operative follow-up. Obes Surg. 2011;21:1887–1893. doi: 10.1007/s11695011-0481-3. - DOI - PubMed
    1. Spaniolas K, Kasten KR, Celio A, Burruss MB, Pories WJ. Postoperative follow-up after bariatric surgery: effect on weight loss. Obes Surg. 2016;26:900–903. doi: 10.1007/s11695-016-2059-6. - DOI - PubMed
    1. Lujan J, Tuero C, Landecho MF, Moncada R, Cienfuegos AJ, Rotellar F, Silva C, Lapuente F, Martínez P, Frühbeck G, Valenti V. Impact of routine and long-term follow-up on weight loss after bariatric surgery. Obes Surg. 2020;11:4293–4299. doi: 10.1007/s11695-020-04788-7. - DOI - PubMed
    1. Mogoanta SS, Paitici S, Mogoanta CA. Postoperative follow-up and recovery after abdominal surgery. IntechOpen. 2021 doi: 10.5772/intechopen.97739. - DOI