Abstract 9711: Association of Preoperative Body Mass Index With 30-Day Major Adverse Cardiovascular Events After Bariatric Surgery
Bibliographic record
Abstract
Introduction: Despite bariatric surgery is the most effective and durable treatment for clinically morbid obesity, its association with intraoperative or 30-Day postoperative cardiovascular events after bariatric surgery is unclear. Hypothesis: To examine the association of preoperative body mass index (BMI) with adverse intraoperative or 30-day postoperative cardiovascular events after bariatric surgery. Methods: Our study extracted data from 785 321 patients who underwent bariatric surgery from 2015 to 2019 in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), which covers more than 90% of all bariatric surgery programs in the United States and Canada. The exposures were preoperative BMI and highest recorded preoperative BMI. The main outcomes were intraoperative or 30-day postoperative major adverse cardiovascular events (MACE). Results: Of the 785 321 patients (mean [SD] age 44.8 [11.8] years; 79.9% women), 1 541 patients suffered at least one MACE event intraoperative or 30-day postoperative bariatric surgery. Compared with patients with a preoperative BMI of 35.0 to 39.9, the multivariable-adjusted ORs (95% CIs) for intraoperative or 30-day postoperative MACE events for patients with preoperative BMI of 40.0 to 44.9, 45.0 to 49.9, 50.0 to 54.9, and 55.0 and greater were 1.05 (95% CI, 0.91-1.21), 1.19 (95% CI, 1.02-1.38), 1.28 (95% CI, 1.07-1.53), and 1.77 (95% CI, 1.50-2.09), respectively ( P for trend < 0.001). Moreover, compared with highest recorded preoperative BMI of 35.0 to 39.9, the multivariable-adjusted ORs (95% CIs) for intraoperative or 30-day postoperative MACE events for patients with preoperative BMI of 40.0 to 44.9, 45.0 to 49.9, 50.0 to 54.9, and 55.0 and greater were 1.20 (95% CI, 1.01-1.41), 1.18 (95% CI, 0.99-1.40), 1.32 (95% CI, 1.09-1.59), and 1.76 (95% CI, 1.48-2.10), respectively ( P for trend < 0.001). Conclusions: In this study, we found that higher preoperative BMI and higher highest recorded BMI were both associated with a higher risk of MACE events intraoperative or 30-day postoperative bariatric surgery. These findings may help improve perioperative cardiovascular optimization and provide evidence for future updates of clinical guidelines regarding bariatric surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".