Predictors for the occurrence of major complications after primary Roux-en-Y gastric bypass surgery.

Background: The risk of developing postoperative complications after primary Roux-en-Y gastric bypass (RYGB) is relatively low. Nevertheless, postoperative complications can have serious consequences in terms of severe morbidity and health care costs. Identification of potential predictors is useful for further reduction of the postoperative complication rate.

Methods: This retrospective study included all patients undergoing primary RYGB between January 2010 and December 2013, using data from a prospectively collected database. Patients' characteristics, operative details and perioperative outcome were analyzed.

Results: A total of 773 patients (14.5% male) were included for analysis, with a mean age of 42.1±10.4 years and a mean Body Mass Index of 42.8±4.3 kg/m2. A total of 66 (8.5%) direct postoperative complications occurred. Clavien-Dindo grade 3a and higher occurred in 55 patients. Univariate analysis identified age (P=0.013), gender (P=0.017), BMI over 50 kg/m2 (P=0.096), hypertension (P=0.099), chronic obstructive pulmonary disease (P=0.002) and previous upper gastrointestinal surgery (P=0.095) as potential predictors. Multivariate logistic regression analysis showed that male gender (OR 2.412; 95%CI [1.212-4.797]) and chronic obstructive pulmonary disease (COPD) (OR 3.716; 95%CI [1.543-8.949]) were found to be independent predictors for the occurrence of major complications after primary RYGB.

Conclusions: This study showed a number of potential predictors, of which male gender and COPD after multivariate regression analysis were found to be independent predictive factors for the occurrence of major complications after primary RYGB.