title: Are results of bariatric surgery different in the Middle East? Early experience of an international bariatric surgery program and an ACS NSQIP outcomes comparison.
abstract: BACKGROUND
  Bariatric operations performed at the Bariatric and Metabolic Institute Abu Dhabi are submitted randomly from the entire surgery volume at Sheikh Khalifa Medical City to the American College of Surgeons (ACS) NSQIP. Our aim is to report our early experience and compare our bariatric surgery outcomes with ACS NSQIP hospitals of similar size.
  
  
  METHODS
  We queried the ACS NSQIP database for bariatric surgery codes between August 2009 and August 2012 for hospitals with >500 beds. Statistical analysis was performed (p < 0.05).
  
  
  RESULTS
  We performed 275 bariatric operations compared with a total of 29,715 at other NSQIP hospitals. The ACS NSQIP bariatric surgery cohort at the Bariatric and Metabolic Institute Abu Dhabi represents 275 of 312 (89.3%) of our entire bariatric surgery volume. Our patients were statistically significantly younger (mean age 36 vs 44.8 years), healthier (American Society of Anesthesiologists scores 1 to 2 in 78.6% vs 35.7%), and heavier (body mass index 47.4 vs 45.5). In addition, we had fewer diabetic (18.5% vs 27.3%) and hypertensive (21.1% vs 52.2%) patients. We performed more Roux-en-Y gastric bypass (69.8% vs 54.5%) and sleeve gastrectomy (24.8% vs 17.2%) and fewer laparoscopic adjustable gastric banding (0.8% vs 22.7%). Outcomes were similar with regard to rates of reoperation, wounds, urinary tract infection, bleeding, thromboembolic, respiratory, and overall complications. We had lower septic, cardiac, and renal failure complications; lower mortality, and longer hospital stay by 0.4 days. We achieved 94.9% 30-day follow-up compared with 90.7% at other ACS NSQIP hospitals.
  
  
  CONCLUSIONS
  This is the first report comparing outcomes of an international bariatric surgery program (Bariatric and Metabolic Institute Abu Dhabi) with ACS NSQIP bariatric surgery programs. Our outcomes are equivalent to ACS NSQIP bariatric surgery programs.
authors.affiliation: Department of Surgery, Sheikh Khalifa Medical City, Abu Dhabi, UAE. nimeri@gmail.com
authors.forename: Abdelrahman
authors.initials: A
authors.lastname: Nimeri
authors.forename: Awadelkarim
authors.initials: A
authors.lastname: Mohamed
authors.forename: Eelaf
authors.initials: E
authors.lastname: El Hassan
authors.forename: Karen
authors.initials: K
authors.lastname: McKenna
authors.forename: Nicolas P
authors.initials: NP
authors.lastname: Turrin
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al Hadad
authors.forename: Nidal
authors.initials: N
authors.lastname: Dehni
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000639:trends; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D015397:Program Evaluation; D012189:Retrospective Studies; D014479:United Arab Emirates / Q000453:epidemiology