ArticleObesity surgery2026
Early Physiologic Derangements for Detection of Major Complications After Bariatric Surgery: A Multicenter Cohort Study.
Article in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03556995 (Score Scale to Assess Risk of Bleeding in Bariatric Surgery), which is not on this map. Not yet cited in PubMed.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Score Scale to Assess Risk of Bleeding in Bariatric Surgery
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Authors and funding
3 authors.
Funding
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Abstract
backgroundEarly recognition of major postoperative complications after bariatric surgery remains challenging. This study evaluated the diagnostic performance of early postoperative clinical and laboratory abnormalities.
methodsA multicenter retrospective cohort study included 9,182 consecutive adults who underwent primary or revisional bariatric surgery at four tertiary centers between September 2016 and December 2020. Prespecified thresholds for routinely monitored postoperative clinical and laboratory parameters were evaluated.
resultsAmong 9,182 patients, 87 (0.95%) developed major postoperative complications. Oxygen desaturation (SpO₂ ≤94%) was the strongest independent predictor (adjusted OR 28.88, 95% CI 14.08-59.24), followed by revisional surgery (adjusted OR 14.94, 95% CI 6.45-34.61), tachypnea, leukocytosis, anemia, severe postoperative pain, older age, and prolonged operative time. Oxygen desaturation demonstrated the highest diagnostic performance (specificity 99.3%; positive likelihood ratio [PLR], 106.7), while severe anemia (Hb ≤ 10 g/dL), fever (≥ 38 °C), and severe postoperative pain also showed excellent rule-in performance (PLRs 10.3, 87.0, and 6.9, respectively). In contrast, tachycardia and tachypnea were sensitive but poorly specific screening indicators. Based on these findings, a practical bedside risk stratification framework integrating baseline procedural risk and early postoperative abnormalities was developed to support timely escalation of care. Internal bootstrap validation demonstrated excellent discrimination (optimism-corrected AUC 0.957) with minimal model optimism.
conclusionsMajor postoperative complications are characterized by physiologic and laboratory abnormalities. Oxygen desaturation, severe anemia, fever, and severe postoperative pain provide highly specific bedside indicators that should prompt early diagnostic evaluation. A structured postoperative assessment framework incorporating these variables may facilitate earlier recognition, timely intervention, and improved patient outcomes.
trial registrationClinicalTrials.gov Identifier: NCT03556995.
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