Bariatric surgery provision in response to the COVID-19 pandemic: retrospective cohort study of a national registry.
Loading...
Authors
McGlone, Emma Rose
Carey, Iain M
Currie, Andrew
Mahawar, Kamal
Welbourn, Richard
Ahmed, Ahmed R
Pring, Chris
Small, Peter K
Khan, Omar A
Issue Date
2023-05-23
Type
Article
Language
en
Keywords
Bariatric surgery , COVID-19 pandemic , Guideline adherence , Obesity , Type 2 diabetes
Alternative Title
Abstract
When surgery resumed following the outbreak of the COVID-19 pandemic, guidelines recommended the prioritization of patients with greater obesity-related co-morbidities and/or higher body mass index. The aim of this study was to record the effect of the pandemic on total number, patient demographics, and perioperative outcomes of elective bariatric surgery patients in the United Kingdom. The United Kingdom National Bariatric Surgical Registry was used to identify patients who underwent elective bariatric surgery during the pandemic (1 yr from April 1, 2020). Characteristics of this group were compared with those of a pre-pandemic cohort. Primary outcomes were case volume, case mix, and providers. National Health Service cases were analyzed for baseline health status and perioperative outcomes. Fisher exact, χ, and Student t tests were used as appropriate. The total number of cases decreased to one third of pre-pandemic volume (8615 to 2930). The decrease in operating volume varied, with 36 hospitals (45%) experiencing a 75%-100% reduction. Cases performed in the National Health Service fell from 74% to 53% (P < .0001). There was no change in baseline body mass index (45.2 ± 8.3 kg/m from 45.5 ± 8.3 kg/m; P = .23) or prevalence of type 2 diabetes (26% from 26%; P = .99). Length of stay (median 2 d) and surgical complication rate (1.4% from 2.0%; relative risk = .71; 95% CI .45-1.12; P = .13) were unchanged. In the context of a dramatic reduction in elective bariatric surgery due to the COVID-19 pandemic, patients with more severe co-morbidities were not prioritized for surgery. These findings should inform preparation for future crises.
Description
Citation
McGlone ER, Carey IM, Currie A, Mahawar K, Welbourn R, Ahmed AR, Pring C, Small PK, Khan OA. Bariatric surgery provision in response to the COVID-19 pandemic: retrospective cohort study of a national registry. Surg Obes Relat Dis. 2023 Nov;19(11):1281-1287. doi: 10.1016/j.soard.2023.05.011. Epub 2023 May 23. PMID: 37365067; PMCID: PMC10204276.
Publisher
Elsevier
License
Copyright © 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Journal
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
Volume
19
Issue
11
PubMed ID
ISSN
1878-7533