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Development of a sleeve gastrectomy risk calculator
Ali Aminian1, Stacy A Brethauer1, Maryam Sharafkhah1
1Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
Summary
This study developed a risk calculator for laparoscopic sleeve gastrectomy (LSG) to predict serious adverse events. The model helps improve surgical decision-making and patient consent for this popular bariatric procedure.
Area of Science:
- Bariatric Surgery
- Surgical Risk Assessment
- Medical Informatics
Background:
- Laparoscopic sleeve gastrectomy (LSG) is increasingly common.
- Accurate risk estimation is crucial for surgical decisions and patient consent.
- A validated risk prediction model for LSG is needed.
Purpose of the Study:
- To develop and validate a risk prediction model for early postoperative morbidity and mortality after LSG.
- To create a risk calculator for predicting adverse events.
- To aid surgical decision-making and informed patient consent.
Main Methods:
- Utilized the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) dataset (2012 for development, 2011 for validation).
- Identified 5871 LSG cases for model development.
- Employed logistic regression analysis to identify predictors of serious adverse events within 30 days.
Main Results:
- The 30-day mortality rate was 0.05% and adverse event rate was 2.4% in 5871 LSG cases.
- Key predictors identified include congestive heart failure, steroid use, male sex, diabetes, bilirubin, BMI, and hematocrit.
- The validated risk model demonstrated good accuracy (c-statistic = 0.682).
Conclusions:
- A risk assessment scoring system for serious adverse events after LSG was developed.
- This tool can enhance surgical decision-making and patient consent processes.
- The model aids in predicting surgical risk for patients and physicians.
