National Bariatric Surgery Registries: an International Comparison

Erman O Akpinar,Simon W Nienhuijs,Perla J Marang- Van De Mheen,Ronald S L Liem,Jan Willem M Greve

doi:10.1007/s11695-021-05359-0

Abstract

IntroductionPooling population-based data from all national bariatric registries may provide international real-world evidence for outcomes that will help establish a universal standard of care, provided that the same variables and definitions are used. Therefore, this study aims to assess the concordance of variables across national registries to identify which outcomes can be used for international collaborations.MethodsAll 18 countries with a national bariatric registry who contributed to The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Global Registry report 2019 were requested to share their data dictionary by email. The primary outcome was the percentage of perfect agreement for variables by domain: patient, prior bariatric history, screening, operation, complication, and follow-up. Perfect agreement was defined as 100% concordance, meaning that the variable was registered with the same definition across all registries. Secondary outcomes were defined as variables having “substantial agreement” (75–99.9%) and “moderate agreement” (50–74.9%) across registries.ResultsEleven registries responded and had a total of 2585 recorded variables that were grouped into 250 variables measuring the same concept. A total of 25 (10%) variables have a perfect agreement across all domains: 3 (18.75%) for the patient domain, 0 (0.0%) for prior bariatric history, 5 (8.2%) for screening, 6 (11.8%) for operation, 5 (8.8%) for complications, and 6 (11.8%) for follow-up. Furthermore, 28 (11.2%) variables have substantial agreement and 59 (23.6%) variables have moderate agreement across registries.ConclusionThere is limited uniform agreement in variables across national bariatric registries. Further alignment and uniformity in collected variables are required to enable future international collaborations and comparison.Graphical abstract

Highlights

Pooling population-based data from all national bariatric registries may provide international real-world evidence for outcomes that will help establish a universal standard of care, provided that the same variables and definitions are used
The 18 national registries together comprise a total of 735.881 patients, from which the 11 participating registries included n = 554.599 (75.4%) patients undergoing bariatric surgery according to the IFSO Global Registry report 2019 [8]
Within the domain “complications”, perfect agreement was found for the 3 variables “postoperative bleeding”, “leak”, and “surgical complication” with the first two having identical definitions and the latter mapped to the same aggregated category

Summary

Introduction

Pooling population-based data from all national bariatric registries may provide international real-world evidence for outcomes that will help establish a universal standard of care, provided that the same variables and definitions are used. Methods All 18 countries with a national bariatric registry who contributed to The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Global Registry report 2019 were requested to share their data dictionary by email. Pooling the datasets from all the national bariatric registries may provide international realworld evidence that will help establish a universal standard of care for the treatment of patients with morbid obesity [5,6,7]. The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) global registry report 2019 includes a total of 833.687 operation records combining all bariatric registries [8].

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Discussion

Conclusion