Abstract
IntroductionThe global prevalence of obesity has increased in recent decades, and bariatric surgery has become a part of the treatment algorithm of obesity. National high-quality registries enable large-scale evaluations of the use and outcome of bariatric surgery and may allow for improved knowledge. The main objective was to evaluate the rate and type of complications after primary bariatric surgery in three North-Western European countries using nationwide registries.Materials and MethodsData from three registries for bariatric surgery were used (January 2015–December 2016). All registries have nationwide coverage with data on patient characteristics, obesity-related diseases, surgical technique, complications, grading of complications, reinterventions, readmissions, and mortality. Eligibility criteria for bariatric surgery were similar and included body mass index of ≥ 40.0 or ≥ 35.0 kg/m2, with one or more obesity-associated diseases.ResultsA total of 35,858 procedures (32,177 primary) were registered. The most common procedure was gastric bypass in the Netherlands (78.9%) and Sweden (67.0%), and sleeve gastrectomy in Norway (58.2%). A total of 904 (2.8%) patients developed major complications after primary surgery and 12 patients (0.04%) died within 30 days. Total number of complications between the registries were comparable (p = 0.939). However, significant differences were seen for Clavien-Dindo Classification grades IIIb and IV (p < 0.001). Pooled readmission rates were 4.3% (n = 1386).DiscussionBariatric surgery is safely performed in the three evaluated countries. Standardization of registries and consensus of variables are essential for international comparison and may contribute to improved quality of treatment across nations.
Highlights
The global prevalence of obesity has increased in recent decades, and bariatric surgery has become a part of the treatment algorithm of obesity
Bariatric surgery has become a part of the treatment algorithm of obesity as significant and sustained weight loss, improvements of related diseases, and health-related quality of life can be assured [1,2,3,4,5]
This study showed similarities in measuring patient’s demographics, obesity-associated diseases, and perioperative outcomes, such as complications, in all three registries
Summary
The global prevalence of obesity has increased in recent decades, and bariatric surgery has become a part of the treatment algorithm of obesity. National high-quality registries enable large-scale evaluations of the use and outcome of bariatric surgery and may allow for improved knowledge. The main objective was to evaluate the rate and type of complications after primary bariatric surgery in three North-Western European countries using nationwide registries. All registries have nationwide coverage with data on patient characteristics, obesity-related diseases, surgical technique, complications, grading of complications, reinterventions, readmissions, and mortality. The global prevalence of obesity and associated diseases has increased considerably in recent decades. Bariatric surgery has become a part of the treatment algorithm of obesity as significant and sustained weight loss, improvements of related diseases, and health-related quality of life can be assured [1,2,3,4,5]. A shift towards high-volume hospitals may have contributed to a reduced risk of procedurerelated complications [9]
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