The goal of the MBSAQIP risk/benefit calculator is to provide accurate, patient-specific risk/benefit information to guide both surgical decision-making and informed consent. The risk/benefit calculator uses 20 patient predictors (e.g., age, ASA class, preoperative BMI, etc.) to predict the chance that patients will have any of 9 different outcomes within 30-days following surgery. These outcomes include:
- Serious Complication (Death; Related, Unplanned Reoperation; Unplanned Admission to the ICU; Organ/Space SSI; Pneumonia; Unplanned Intubation; Pulmonary Embolism; On Ventilator > 48 hours; Progressive Renal Insufficiency; Acute Renal Failure; Stroke/Cerebral Vascular Accident; Coma > 24 hours; Cardiac Arrest Requiring CPR; Myocardial Infarction; Transfusion; Vein Thrombosis Requiring Therapy; Sepsis; Septic Shock)
- Any Complication (Superficial Incisional SSI; Deep Incisional SSI; Organ/Space SSI; Wound Disruption; Pneumonia; Unplanned Intubation; Pulmonary Embolism; On Ventilator > 48 hours; Progressive Renal Insufficiency; Acute Renal Failure; Urinary Tract Infection; Stroke/Cerebral Vascular Accident; Coma > 24 hours; Peripheral Nerve Injury; Cardiac Arrest Requiring CPR; Myocardial Infarction; Transfusion; Vein Thrombosis Requiring Therapy; Sepsis; Septic Shock; Unplanned Admission to the ICU; Reoperation/Intervention/Readmission for one of the following: Abdominal Pain, Not Otherwise Specified; Anastomotic Ulcer; Anastomotic/Staple Line Leak; Band Erosion; Band Slippage/Prolapse; Bile Reflux Gastritis; Bleeding; Cardiac, Not Otherwise Specified (arrhythmias, congestive heart failure); Cerebral Vascular Accident; GI Perforation; Gallstone Disease; Gastric Distention; Gastro-Gastric Fistula; Incisional Hernia; Infection/Fever; Internal Hernia; Intestinal Obstruction; LAGB - Port, Tubing or Band Problem; Myocardial Infarction; Nausea and Vomiting, Fluid, Electrolyte, or Nutritional Depletion; Other Abdominal Sepsis; Other Respiratory Failure; Pneumonia; Pulmonary Embolism; Renal Insufficiency; Strictures/Stomal Obstruction; Vein Thrombosis Requiring Therapy; Wound Infection/Evisceration)
- Leak (Reoperation/Intervention/Readmission for Anastomotic/Staple Line Leak)
- Bleed (Transfusion of RBCs or Reoperation/Intervention/Readmission for Bleeding)
- Surgical Site Infection (Superficial Incisional SSI, Deep Incisional SSI, Organ/Space SSI)
In addition, the risk/benefit calculator uses the same 20 patient predictors to predict the chance that patients will be in remission at 1 year after surgery for up to 5 different weight-related comorbidities. Note that remission predictions for a particular weight-related comorbidity are only provided if the preoperative weight-related comorbidity is entered as a patient predictor. The 5 weight-related comorbidities include:
- Sleep Apnea
Lastly, the risk/benefit calculator uses the same 20 patient predictors to predict the BMI, weight change, and percent total weight change trajectories for patients up to 1 year after surgery.
The risk/benefit calculator was built using data collected from over 775,000 operations at 925 centers participating in MBSAQIP from January 1, 2013 - June 30, 2018. Entering the most complete and accurate patient information will provide the most precise risk/benefit information. However, the estimates can still be calculated if some of the patient information is unknown.