Coblijn Usha K, Lagarde Sjoerd M, de Raaff Christel A L, de Castro Steve M, van Tets Willem F, Jaap Bonjer H, van Wagensveld Bart A
Department of Surgery, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands.
Department of Surgery, Academisch Medisch Centrum, Amsterdam, The Netherlands.
Surg Obes Relat Dis. 2016 Sep-Oct;12(8):1504-1512. doi: 10.1016/j.soard.2016.04.003. Epub 2016 Apr 6.
The Obesity Surgery Mortality Risk Score (OS-MRS) is a validated instrument for mortality risk prediction in patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures classifying patients into low risk (class A), intermediate risk (class B), and high risk (class C).
The primary aim of this study was to evaluate the accuracy of the OS-MRS in predicting postoperative complications after LRYGB. Secondarily, the postoperative complication rate between primary and revisional LRYGB was systematically analyzed.
The Obesity Center Amsterdam, located in a large teaching hospital, in Amsterdam, The Netherlands.
The OS-MRS was applied to a consecutive database of patients who underwent LRYGB from November 2007 onwards. Postoperative complications were scored according to the Clavien-Dindo classification. Revisional LRYGB was separately analyzed.
LRYGB was performed in 1667 patients either as a primary (81.5%) or revisional (18.5%) procedure. The majority (n = 1371, 82.2%) were female, mean age 44.6 (standard deviation 14.4) years and mean body mass index 44.2 (6.5) kg/m. Nine hundred and four (54.2%) were OS-MRS class A, 642 class B (38.5%), and 121 (7.3%) class C. Complications occurred in 143 (10.5%) and 44 (14.2%) patients after primary and revisional surgery, respectively. In both primary and revisional LRYGB, there was no association between complications and the OS-MRS classification. Subanalysis comparing primary with revisional LRYGB found a significant association between revisional surgery and the development of severe complications (Clavien-Dindo≥3) (P = .003) and mortality (P = .017).
The OS-MRS was not an accurate predictor for postoperative complications in patients who underwent primary or revisional LRYGB. As in other studies, revisional surgery is an independent risk factor for the development of severe complications.
肥胖手术死亡率风险评分（OS - MRS）是一种经过验证的工具，用于预测接受腹腔镜Roux - Y胃旁路术（LRYGB）患者的死亡风险，将患者分为低风险（A类）、中度风险（B类）和高风险（C类）。
本研究的主要目的是评估OS - MRS在预测LRYGB术后并发症方面的准确性。其次，系统分析初次与翻修LRYGB术后的并发症发生率。
位于荷兰阿姆斯特丹一家大型教学医院的阿姆斯特丹肥胖中心。
将OS - MRS应用于2007年11月起接受LRYGB患者的连续数据库。根据Clavien - Dindo分类对术后并发症进行评分。对翻修LRYGB进行单独分析。
1667例患者接受了LRYGB手术，其中初次手术占81.5%，翻修手术占18.5%。大多数患者（n = 1371，82.2%）为女性，平均年龄44.6（标准差14.4）岁，平均体重指数44.2（6.5）kg/m²。904例（54.2%）为OS - MRS A类，642例为B类（38.5%），121例（7.3%）为C类。初次手术和翻修手术后分别有143例（10.5%）和44例（14.2%）患者发生并发症。在初次和翻修LRYGB中，并发症与OS - MRS分类之间均无关联。比较初次与翻修LRYGB的亚组分析发现，翻修手术与严重并发症（Clavien - Dindo≥3）的发生（P = .003）和死亡率（P = .017）之间存在显著关联。
OS - MRS并非接受初次或翻修LRYGB患者术后并发症的准确预测指标。与其他研究一样，翻修手术是发生严重并发症的独立危险因素。
