title: Use of the obesity surgery mortality risk score to predict complications of laparoscopic bariatric surgery.
abstract: BACKGROUND
  This study aimed to evaluate the role of the Obesity Surgery Mortality Risk Score (OS-MRS) to predict the risk of post-operative adverse events, in addition to death, from any laparoscopic bariatric procedure.
  
  
  METHODS
  The OS-MRS was applied to consecutive patients at a single hospital during October 2008-September 2009. The composite end point comprised one or more of the following adverse events: mortality, re-intervention, re-admission to hospital, venous thromboemobolism, or blood transfusion.
  
  
  RESULTS
  There were 381 patients (men, 19%). The median age was 43 years (range, 19-67 years), with 42% patients aged ≥45 years. The median weight was 126 kg (75-295 kg) and median BMI 46 kg/m(2) (30-84 kg/m(2)); 37% had BMI ≥50 kg/m(2). Twenty-seven percent of patients had hypertension and 3% had a past history of venous thromboembolism. The OS-MRS classes were A (60.1%), B (35.9%), or C (4.0%). Operations comprised adjustable gastric band (37%), Roux-en-Y gastric bypass (54%), sleeve gastrectomy (8%), or biliopancreatic diversion (1%). Of the operations, 1.6% were revisional procedures. An adverse outcome occurred in 19 patients, with distribution in 3.5% of class A patients, 5.8% of class B, and 20.0% of class C (A vs. B, P = 0.451; A vs. C, P = 0.002; B vs. C, P = 0.025). There was one death: OS-MRS class C. On multivariate analysis, OS-MRS (class C vs. A or B; Odds Ratio [OR], 4; P = 0.050) and type of operation (band vs. bypass or sleeve; OR, 9.2; P = 0.033) were independently predictive of the composite end point.
  
  
  CONCLUSIONS
  OS-MRS and type of the bariatric operation are independently predictive of the risk of post-operative adverse events.
authors.affiliation: Department of Minimally Invasive Upper GI and Bariatric Surgery, Nuffield Health Leeds Hospital, 2 Leighton Street, Leeds, LS1 3EB, UK. a.sarela@leeds.ac.uk
authors.forename: Abeezar I
authors.initials: AI
authors.lastname: Sarela
authors.forename: Simon P L
authors.initials: SP
authors.lastname: Dexter
authors.forename: Michael J
authors.initials: MJ
authors.lastname: McMahon
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods / Q000401:mortality*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D018570:Risk Assessment; D055815:Young Adult