Over 93 million Americans were afflicted with obesity in 2015-2016 according to the CDC data, which also found that obesity is on the rise.
With the increase in obesity comes an increase in the obesity-related conditions which could severely damage a person's quality of life, including heart disease, stroke, diabetes, crippling arthritis, and certain types of cancer.
Excessively overweight individuals often look at various weight loss interventions in order to combat their obesity. One of the most common interventions to which obese individuals turn is a weight loss surgery, also known as bariatric surgery.
This procedure makes changes to a patient's digestive system to help them lose weight by limiting how much they can eat or by reducing the absorption of nutrients, or both.
There are four common types of bariatric surgery, including gastric bypass, laparoscopic adjustable gastric banding, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch.
Just like any other surgical procedure, all forms of bariatric surgery are major procedures that can pose serious risks and side effects.
Although the risk of having major complications or dying from the surgery is low - only 0.5 percent - some patients may be at risk more than others, especially those with certain conditions and risk factors.
Risks and side effects vary by bariatric procedure but may include bleeding, blood clots, gallstones, hernia, and more.
Therefore, it is extremely important that physicians asses the patients prior to bariatric surgery to estimate a chance of developing serious adverse event post-surgery, especially high-risk patients with risk factors such as congestive heart failure, chronic steroid use, male gender, diabetes, high BMI, elevated preoperative serum bilirubin level, low hematocrit, paraplegia, dyspnea at rest, and more.
A team of researchers at Cleveland Clinic has developed the Bariatric Surgery Calculator app with a goal to help physicians asses their patients before their weight loss surgery and choose the best bariatric procedure based on given parameters and results.
The Bariatric Surgery Calculator app includes 3 evidence-based decision-making tools: a sleeve gastrectomy (SG) risk calculator, a post-discharge venous thromboembolism (VTE) risk calculator, and a scoring system for evidence-based selection between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) surgery.
All tools are based on the scoring systems developed by the same team from Cleveland Clinic to help physicians answer important clinical questions in the field of bariatric surgery and ensure the patient and physician understand the relative risk and benefit of this surgery.
A sleeve gastrectomy (SG) is the most common bariatric procedure performed worldwide. The first calculator in this app – the SG risk calculator – tries to estimate serious adverse events that may happen after a sleeve gastrectomy.
These estimations are based on data of 5,871 SG patients and seven risk factors identified to be associated with early postoperative morbidity and mortality after sleeve gastrectomy procedure, including congestive heart failure, chronic steroid use, male gender, diabetes, high BMI, elevated preoperative serum bilirubin level, and low hematocrit.
Venous thromboembolism (VTE) is the most common cause of death after bariatric surgery and mostly occurs after hospital discharge.
The second calculator in the app – a post-discharge VTE risk assessment tool - utilizes ten independent risk factors associated with post-discharge VTE to identify high-risk patients who would benefit from extended VTE prophylaxis after the discharge.
Finally, the third tool – the Individualized Metabolic Surgery (IMS) scoring system – is the evidence-based selection of metabolic surgery, trying to figure out if sleeve gastrectomy surgery or Roux-en-Y gastric bypass offers better risk/benefit and long-term remission for patients with type 2 diabetes.
The Bariatric Surgery Calculator app is straightforward and easy to use. All tools are displayed on the main screen.
Tapping on each opens an individual calculator/scoring system. The physicians can enter the patient's data into the calculator to receive a score/estimate for a particular patient.
For example, they would get estimates of patient's chance of developing a serious post-operative adverse event after sleeve gastrectomy or a VTE post-bariatric surgery.
The third tool can help physicians decide which of the two procedures (RYGB or SG) would be the best for their patient with type 2 diabetes.
The calculation/estimate is given below the calculator, indicating the steps that should be taken. For example, if the patient has moderate diabetes gastric bypass would be recommended, while for the more severe cases the app would suggest sleeve gastrectomy.
Each of the calculators provides a reference, which is basically the resource used for the creation of the particular tool, linking to the Cleveland Clinic's RiskCalc website.
Users can also view the information about the app, the tools developers, view all references or visit RiskCalc website for more information.
The app is available for free on iOS and Android platform, however, the Android version of the app is not available worldwide.
Despite its simplicity, the Bariatric Surgery Calculator app offers a wonderful set of tools for evidence-based risk stratification and the best bariatric procedure selection.
I would highly recommend it to all physicians who assess and advise patients before a weight loss surgery.
Benefit: The app is designed for physicians and their patients helping them decide which bariatric procedure may offer the best results