Metabolic Bariatric Surgery Across the IFSO Chapters: Key Insights on the Baseline Patient Demographics, Procedure Types, and Mortality from the Eighth IFSO Global Registry Report

Abstract

Introduction: The International Federation for Surgery for Obesity and Metabolic Disorders (IFSO) Global Registry aims to provide descriptive data about the caseload and penetrance of surgery for metabolic disease and obesity in member countries. The data presented in this report represent the key findings of the eighth report of the IFSO Global Registry.

Methods: All existing Metabolic and Bariatric Surgery (MBS) registries known to IFSO were invited to contribute to the eighth report. Aggregated data was provided by each MBS registry to the team at the Australia and New Zealand Bariatric Surgery Registry (ANZBSR) and was securely stored on a Redcap™ database housed at Monash University, Melbourne, Australia. Data was checked for completeness and analyzed by the IFSO Global Registry Committee. Prior to the finalization of the report, all graphs were circulated to contributors and to the global registry committee of IFSO to ensure data accuracy.

Results: Data was received from 24 national and 2 regional registries, providing information on 502,150 procedures. The most performed primary MBS procedure was sleeve gastrectomy, whereas the most performed revisional MBS procedure was Roux-en-Y gastric bypass. Asian countries reported people with lower BMI undergoing MBS along with higher rates of diabetes. Mortality was a rare event.

Conclusion: Registries enable meaningful comparisons between countries on the demographics, characteristics, operation types and approaches, and trends in MBS procedures. Reported outcomes can be seen as flags of potential issues or relationships that could be studied in more detail in specific research studies.

Keywords: Demographics; International trends; Metabolic bariatric surgery; Registry.

Fig. 1

Process for data collection and collation

Fig. 2

Number of metabolic bariatric surgical procedures per country or region. NB: X-axis is a logscale. Twenty-four countries and 2 regional registries contributed 502,150 procedures, with 449,815 (89.5%) primary procedures and 52,335 (10.5%) revisional procedures. Michigan is a state in the United States of America, and 39 of its 41 sites also contribute to the MBSAQIP (USA) Registry, meaning 10,437 procedures are potentially represented twice in this graph. The UK data is from 2021

Fig. 3

Proportion of participants in registries recorded as female or male. Differences in overall numbers in each registry recording sex may reflect people identifying as a sex other than male or female or the field being incompletely recorded

Fig. 4

MBS procedure type. *Potential for procedures to be represented twice due to possible overlaps with the datasets of the USA and Michigan. a Primary MBS procedures (n = 449,815). b Revisional procedures (n = 31,278; excluded 21,057 cases labelled revision/conversion cases from United States of America that did not have a procedure type specified)

Fig. 5

a Primary MBS types by country or region (n = 449,815). b Revisional MBS types by country or region (n = 52,335). Malaysia (n = 1), Uzbekistan (n = 5), and South Africa (n = 3) cannot be graphically displayed. The United States of America reported an additional 21,057 revisional cases labelled “revision/conversion” that are not able to be displayed graphically. This means the breakdown of procedures displayed in this graph may not be representative