Comparison of perioperative bariatric complications using 2 large databases: does the data add up?

Abstract

BackgroundThe Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database is a prospective clinical database that looks at short-term (30-day) outcomes of bariatric surgery. The Texas Inpatient Public Use Data File (PUDF) is an administrative database that uses hospital discharge information to compile data on admission and discharge diagnoses. ObjectiveTo determine interdatabase reliability for common bariatric complications. SettingUniversity hospital, United States MethodsThe Texas Inpatient PUDF and MBSAQIP were queried for patients undergoing sleeve gastrectomy and gastric bypass in the year 2015. Admission diagnoses of morbid obesity with a discharge diagnosis of bariatric surgery status and also the International Classification of Diseases 9 Clinical Modification and Current Procedural Terminology procedure codes for bariatric surgeries were queried. The same postoperative complications were examined in both databases. ResultsThere were 137,291 patients in MBSAQIP and 9474 patients in the PUDF undergoing bariatric surgery. Patients in the PUDF had greater adjusted and unadjusted odds ratio for acute renal failure, cardiac arrest and postoperative myocardial infarction, pneumonia, progressive renal failure and postoperative sepsis. ConclusionThere is a significant difference in the rates of perioperative complications of bariatric surgery when different databases are used. If surgeons are to be graded or potentially financially affected by these outcome metrics, the proper use of and interpretation of data is paramount and quality monitoring organizations should not use only administrative databases as the primary method to measure quality.