Implementation of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program and outcomes of bariatric surgery

Introduction: This study evaluates the performance of bariatric surgery prior to and after the implementation of Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Methods: The eras prior to (2007-2015) and after (2016-2018) the transition to MBSAQIP were compared for patients, operations and outcomes using adjusted logistic regression estimates. Results: Thirty-day surgical (6%vs.2.9%,p < 0.01) and medical (3.4%vs.1.7%,p < 0.01) complications rates were reduced over the period 2007 through 2018. Th use of sleeve gastrectomy has steadily increased from 2010 to 2018 (14%vs.66.6%,p < 0.01). The proportion of patients who were discharged early continued to rise (9.8%vs.46.9%,p < 0.01) from 2007 to 2018. The MBSAQIP period was associated with reduced odds for 30-day surgical (OR = 0.86,CI = [0.81-0.91]) and medical (OR = 0.81,CI = [0.75-0.88]) complications. Implementation of the MBSAQIP was also predictive of early discharge (OR = 1.93,CI = [1.90-2.00]). Conclusion: The type of bariatric procedure, in addition to trends in morbidity and hospital stays, gradually changed from 2007 to 2018. Our findings suggest that outcomes of bariatric operations have improved over the past decade. The MBSAQIP era is associated with lower rates of complications and greater likelihood of early discharge, independent of the procedure type.