Risk/Benefit Calculator Predicts Patient Outcomes

A new surgical risk/benefit calculator that will providemetabolic and bariatric surgeons and their patients with accurate,patient-specific information to guide surgical decision making and informedconsent will soon be released by the Metabolic and Bariatric SurgeryAccreditation and Quality Improvement Program (MBSAQIP).

“This calculator isextremely meaningful in that it uses millions of cases within the uniqueclinical registry data from the MBSAQIP to address three important areas – firstit predicts rates of untoward events; second, it predicts weight loss; andthird, and possibly most important, it predicts rates of disease resolution,including such things as diabetes, hypertension, sleep apnea, and others. Thisinformation is crucial for both patients and providers,” said Clifford Y. Ko,MD, MS, MSHS, FACS, director of the American College of Surgeons (ACS) Divisionof Research and Optimal Patient Care.

The Bariatric Surgical Risk/Benefit Calculator was builtusing data collected from more than 775,000 operations from 925 centersparticipating in MBSAQIP from January 1, 2013, through June 30, 2018. For30-day outcomes, the calculator uses 20 patient predictors, such as age,American Society of Anesthesiologists Physical Status classification, andpreoperative body mass index (BMI) to predict the likelihood that patients willexperience any of nine different outcomes within the first 30 days after anoperation. Examples of these outcomes include surgical site infections,unplanned reoperations, and death.

The calculator can predict the patient’s BMI, weight, andtotal weight change percentage trajectories up to one year after an operativeprocedure. To assist with patients’ understanding of the predictions, thecalculator provides a summary report designed for patients to share theinformation with their families and other multidisciplinary team membersinvolved in their care.

“The MBSAQIP Calculator is a unique tool to aid patients andsurgeons alike. This tool will allow for a patient-centered approach to riskassessment, procedure selection, and has the additional significant advantageof determining and maintaining progress after surgery with weight loss andcomorbidity improvement milestones for the critical first post-operative year.With over 700,000 cases and 900 hospitals participating over five years, this valuableinstrument has the potential to deliver precision care to over 250,000 patientsannually,” said John Magaña Morton, MD, MPH, MHA, FACS, FASMBS, ABOM, vicechair, quality, and division chief, bariatric and minimally invasive surgery,Yale University School of Medicine, and chair of the ACS Committee forMetabolic and Bariatric Surgery (CMBS).

The calculator was introduced at the 2019 ACS Quality andSafety Conference in Washington, DC, and will be available to clinicians in thecoming week. The calculator will be located both on the ACS website for allmetabolic and bariatric surgery centers to use as well as the data registryportal for MBSAQIP-accredited centers.