Evaluating the safety of bariatric surgery for weight loss in class I obesity: A propensity-matched analysis of North American data.

BACKGROUND

Bariatric surgery is an effective treatment for severe obesity. However, there has been an evolving role for bariatric surgery as a primary treatment in the management of class I obesity.

OBJECTIVES

We aimed to assess the safety of surgery by directly comparing surgical outcomes of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in class I obesity (body mass index [BMI] 30-35 kg/m) with those with class II obesity (BMI 35-40 kg/m) and higher (BMI >40 kg/m) using an analysis of a large-scale matched-patient cohort analysis.

SETTING

Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, United States and Canada.

METHODS

We performed a retrospective analysis using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, which collects patient information from >790 bariatric surgery centers in North America. Patients included in our analysis underwent surgery in the years 2015 and 2016 and had either LRYGB or LSG for weight loss.

RESULTS

Initial analysis included 274,091 patients. Propensity-matching resulted in 9104 patients for analysis in each of the class I and class II and higher groups. The overall major complication rate between the 2 matched groups was 3.9% for class I and 3.5% for class II and higher (P = .11). We did not find that class I obesity was associated with an increased risk of 30-day complication or death.

CONCLUSIONS

In our analysis of propensity-matched patients undergoing LSG and LRYGB for weight loss, class I obesity did not have statistically higher risk of postoperative complication rates compared with class II and higher.