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Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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BackgroundAround 20% of bariatric surgery patients develop a short- or long-term complication.ObjectiveAim of this study was to develop a risk model predicting complications: the Bariatric Surgery Index for Complications (BASIC).SettingThe Obesity Center Amsterdam, located in a large teaching hospital, in Amsterdam, The Netherlands.MethodsA prospective consecutive database including patients operated between November 2007 and February 2015 was used. For the BASIC, analysis according to the TRIPOD statement was performed to identify risk factors for complications. Class I included patients with zero to one risk factor, class II patients with two risk factors, and class III patients with three or more risk factors.ResultsOf 1709 analyzed patients, mean age was 45 years (±SD 10.7), 1393 (81.5%) were female; mean body mass index was 44.5 kg/m2 (6.8). Overall, 271 (15.9%) patients developed a complication of which 197 (72.5%) occurred within 30 days. Predictors in multivariable analysis were use of anticoagulants (odd’s ratio (OR) 1.5); chronic obstructive pulmonary disease (OR 2.3); dyslipidemia (OR 1.4); gender (OR 1.4); psychiatric history (OR 1.3); and revisional surgery (OR 1.5). In class I, 13.5% (181 out of 1338) experienced complications, in class II 58 (21.6%) of the 269 patients and in class III 32 (31.4%) of the 102 patients, respectively. There was a significant difference (p < 0.001) in both overall and 30 day complications.ConclusionThe BASIC uses six preoperative variables to classify patients in a low-, intermediate-, or high-risk group for postoperative complications after bariatric surgery.

DNR patients have higher mortality rates due to poor health status. Resuscitation preferences on their own are not associated with early mortality after hip fracture surgery.