Evaluating National Trends in Bleeding Associated with Metabolic Bariatric Surgery over 7 Years.
Publication/Presentation Date
10-1-2025
Abstract
BACKGROUND: Post-operative bleeding is a known complication after metabolic bariatric surgery (MBS). This study evaluates the national trends in the rates of bleeding, factors associated with bleeding, and impact of bleeding complication on other outcomes.
METHODS: MBSAQIP database from 2015 to 2021 was utilized to perform multivariable regression analysis of pre-operative factors associated with bleeding for all MBS, as well as gastric bypass (RYGB) and sleeve gastrectomy (SG) subsets. Propensity matching using pre-operative factors was performed for patients with and without a bleeding complication to compare peri-operative outcomes.
RESULTS: Rates of post-operative bleeding decreased overall from 1.01% in 2015 to 0.69% in 2021. RYGB (OR 2.08, p < 0.01) had a higher risk of bleeding compared to SG. Open surgical approach (OR 2.33, p < 0.01), therapeutic anticoagulation (OR 2.49, p < 0.01), renal insufficiency (OR 1.61, p < 0.01), and history of MI (OR 1.26, p < 0.01) were highly associated with bleeding. Pre-operative demographics associated with increased bleeding risk included older age (OR 1.16-1.31, p < 0.01), male gender (OR 1.10, p < 0.01) and Asian race (OR 1.47, p < 0.01). Staple line reinforcement (OR 0.76, p < 0.01) and oversewing (OR 0.79, p < 0.01) were protective against bleeding after SG. Bleeding was associated with 18 times higher risk of major complications (42.57% vs 2.33%, p < 0.01) and 8 times higher risk of death (1.06% vs 0.13%, p < 0.01).
CONCLUSIONS: The risk of bleeding after MBS has decreased over the past 7 years. Patients suffering a bleeding complication have a markedly higher risk of major complications and death. Therefore, identifying methods to reduce post-operative bleeding should be a priority.
Volume
35
Issue
10
First Page
4079
Last Page
4086
ISSN
1708-0428
Published In/Presented At
Bharani, T., Agarwal, D., Nimeri, A., Tsai, T., Ghushe, N., Robinson, M., Tatarian, T., Tavakkoli, A., & Sheu, E. (2025). Evaluating National Trends in Bleeding Associated with Metabolic Bariatric Surgery over 7 Years. Obesity surgery, 35(10), 4079–4086. https://doi.org/10.1007/s11695-025-08231-7
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
40975719
Department(s)
Administration and Leadership
Document Type
Article