Bariatric Surgery Candidate, COVID-19
Conditions
Brief summary
The National Bariatric Surgical Registry (NBSR) is a prospectively collected database for all patients undergoing elective bariatric surgery in the UK. It was used to identify patients that underwent elective bariatric surgery during the pandemic (one year from 1st April 2020). Characteristics of this group were compared with a pre-pandemic cohort (one year from 1st September 2018).
Interventions
OTHERCOVID-19 pandemic
Pandemic group underwent surgery during the COVID-19 pandemic. Pre-pandemic group underwent surgery prior to the pandemic.
Sponsors
The Royal College of Surgeons of England
Imperial College London
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
All patients listed on National Bariatric Surgical Registry (NBSR) that underwent elective bariatric surgery during the pandemic (one year from 1st April 2020) or prior to the pandemic (one year from 1st September 2018) -
Exclusion criteria
\- Where a variable was 'not recorded' this point was excluded from analysis. For age, gender, procedure type and provider the records were 100% complete, for BMI at time of surgery there was 5% missing data and for other variables the missing value rate was 2% or lower.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Revisions | 1 year | Number of patients undergoing revisional bariatric surgery |
| Private | 1 year | Number of patients undergoing elective bariatric surgery in the private sector |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Completed Laparoscopically | 1 year | Number of cases completed laparoscopically for patients undergoing elective bariatric surgery in the NHS |
| Length of Stay | 1 year | Length of stay for NHS patients undergoing bariatric surgery in days |
| Surgical Complications | 1 year | Number of surgical complications in patients undergoing elective bariatric surgery in the NHS |
| Presence of Second Consultant | 1 year | Presence of second consultant in elective bariatric cases undertaken in the NHS |
Countries
United Kingdom
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Pre-pandemic NHS Patients Patients that underwent elective bariatric surgery in a control period prior to the pandemic (one year from 1st September 2018) in the NHS | 6,384 |
| Pandemic NHS Patients Patients that underwent elective bariatric surgery during the pandemic (one year from 1st April 2020) in the NHS
COVID-19 pandemic: Pandemic group underwent surgery during the COVID-19 pandemic. Pre-pandemic group underwent surgery prior to the pandemic. | 1,566 |
| Total | 7,950 |
Baseline characteristics
| Characteristic | Pre-pandemic NHS Patients | Pandemic NHS Patients | Total |
|---|---|---|---|
| Age, Continuous | 45.8 years STANDARD_DEVIATION 11.4 | 46.3 years STANDARD_DEVIATION 11.6 | 45.9 years STANDARD_DEVIATION 11.4 |
| BMI at time of surgery kg/m2 | 45.5 kg/m^2 STANDARD_DEVIATION 8.3 | 45.2 kg/m^2 STANDARD_DEVIATION 8.3 | 45.4 kg/m^2 STANDARD_DEVIATION 8.3 |
| Cardiovascular disease | 307 Participants | 66 Participants | 373 Participants |
| Duration of T2DM less than 5 years/ 5-10 years/ more than 10 years; n 5-10 years | 314 Participants | 83 Participants | 397 Participants |
| Duration of T2DM less than 5 years/ 5-10 years/ more than 10 years; n Less than 5 years | 904 Participants | 202 Participants | 1106 Participants |
| Duration of T2DM less than 5 years/ 5-10 years/ more than 10 years; n More than 10 years | 364 Participants | 100 Participants | 464 Participants |
| Hypertension | 2192 Participants | 550 Participants | 2742 Participants |
| Liver disease | 449 Participants | 110 Participants | 559 Participants |
| Obstructive sleep apnoea (OSA) No indication of OSA | 4511 Participants | 1090 Participants | 5601 Participants |
| Obstructive sleep apnoea (OSA) OSA off treatment | 358 Participants | 63 Participants | 421 Participants |
| Obstructive sleep apnoea (OSA) OSA on treatment | 1402 Participants | 400 Participants | 1802 Participants |
| Race and Ethnicity Not Collected | — | — | 0 Participants |
| Sex: Female, Male Female | 5058 Participants | 1266 Participants | 6324 Participants |
| Sex: Female, Male Male | 1326 Participants | 300 Participants | 1626 Participants |
| T2DM on treatment/ pre-T2DM/ no T2DM no T2DM | 4393 Participants | 1077 Participants | 5470 Participants |
| T2DM on treatment/ pre-T2DM/ no T2DM pre-T2DM | 242 Participants | 72 Participants | 314 Participants |
| T2DM on treatment/ pre-T2DM/ no T2DM T2DM on treatment | 1635 Participants | 397 Participants | 2032 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 8,615 | 1 / 2,930 |
| other Total, other adverse events | 151 / 8,615 | 38 / 2,930 |
| serious Total, serious adverse events | 0 / 8,615 | 0 / 2,930 |
Outcome results
Primary
Private
Number of patients undergoing elective bariatric surgery in the private sector
Time frame: 1 year
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pre-pandemic | Private | 2084 Participants |
| Pandemic | Private | 1356 Participants |
Primary
Revisions
Number of patients undergoing revisional bariatric surgery
Time frame: 1 year
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pre-pandemic | Revisions | 746 Participants |
| Pandemic | Revisions | 316 Participants |
Secondary
Completed Laparoscopically
Number of cases completed laparoscopically for patients undergoing elective bariatric surgery in the NHS
Time frame: 1 year
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pre-pandemic | Completed Laparoscopically | 6268 Participants |
| Pandemic | Completed Laparoscopically | 1552 Participants |
Secondary
Length of Stay
Length of stay for NHS patients undergoing bariatric surgery in days
Time frame: 1 year
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pre-pandemic | Length of Stay | 2.17 days | Standard Deviation 3.84 |
| Pandemic | Length of Stay | 2.0 days | Standard Deviation 3.43 |
Secondary
Presence of Second Consultant
Presence of second consultant in elective bariatric cases undertaken in the NHS
Time frame: 1 year
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pre-pandemic | Presence of Second Consultant | 289 Participants |
| Pandemic | Presence of Second Consultant | 56 Participants |
Secondary
Surgical Complications
Number of surgical complications in patients undergoing elective bariatric surgery in the NHS
Time frame: 1 year
Population: refers to NHS patients only, whereas the adverse events tables refer to the population as a whole (NHS and private). Hence the different numbers of participants analysed.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pre-pandemic | Surgical Complications | 126 Participants |
| Pandemic | Surgical Complications | 22 Participants |