Effect of BMI on safety of bariatric surgery during the COVID-19 pandemic, procedure choice, and safety protocols – An analysis from the GENEVA Study

Male Gastric Bypass 610 Bariatric Surgery BMI; bariatric surgery; covid-19; metabolic surgery; obesity; obesity surgery; pandemic; resuming elective surgery; Sars-Cov-2; body mass index; female; gastrectomy; humans; male; pandemics; retrospective studies; treatment outcome; weight loss; bariatric surgery; gastric bypass; laparoscopy; obesity Resuming Elective surgery Article Body Mass Index BMI 03 medical and health sciences 0302 clinical medicine Gastrectomy Weight Loss 617 Humans Obesity Pandemics Retrospective Studies Bariatric surgery 2. Zero hunger Pandemic SARS-CoV-2 BMI; Bariatric surgery; COVID-19; Metabolic surgery; Obesity; Obesity surgery; Pandemic; Resuming Elective surgery; SARS-CoV-2 COVID-19 ResearchInstitutes_Networks_Beacons/mcrc; name=Manchester Cancer Research Centre Obesity, Morbid 3. Good health Obesity surgery Treatment Outcome BMI; Bariatric surgery; COVID-19; Metabolic surgery; Obesity; Obesity surgery; Pandemic; Resuming Elective surgery; SARS-CoV-2; Body Mass Index; Female; Gastrectomy; Humans; Male; Pandemics; Retrospective Studies; Treatment Outcome; Weight Loss; Bariatric Surgery; COVID-19; Gastric Bypass; Laparoscopy; Obesity, Morbid Female Laparoscopy Metabolic surgery
DOI: 10.1016/j.orcp.2022.06.003 Publication Date: 2022-06-08T06:33:19Z
AUTHORS (431)
ABSTRACT
It has been suggested that patients with a Body Mass Index (BMI) of > 60 kg/m2 should be offered expedited Bariatric Surgery (BS) during the Coronavirus Disease-2019 (COVID-19) pandemic. The main objective of this study was to assess the safety of this approach.We conducted a global study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into three groups according to their preoperative BMI - Group I (BMI<50 kg/m2), Group II (BMI 50-60 kg/m2), and Group III (BMI>60 kg/m2). The effect of preoperative BMI on 30-day morbidity and mortality, procedure choice, COVID-19 specific safety protocols, and comorbidities was assessed.This study included 7084 patients (5197;73.4 % females). The mean preoperative weight and BMI were 119.49 ± 24.4 Kgs and 43.03 ± 6.9 Kg/m2, respectively. Group I included 6024 (85 %) patients, whereas Groups II and III included 905 (13 %) and 155 (2 %) patients, respectively. The 30-day mortality rate was higher in Group III (p = 0.001). The complication rate and COVID-19 infection were not different. Comorbidities were significantly more likely in Group III (p = <0.001). A significantly higher proportion of patients in group III received Sleeve Gastrectomy or One Anastomosis Gastric Bypass compared to other groups. Patients with a BMI of > 70 kg/m2 had a 30-day mortality of 7.7 % (2/26). None of these patients underwent a Roux-en-Y Gastric Bypass.The 30-day mortality rate was significantly higher in patients with BMI > 60 kg/m2. There was, however, no significant difference in complications rates in different BMI groups, probably due to differences in procedure selection.
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