OR-MRS Cannot be used for Morbidity in Laparoscopic Sleeve Gastrectomy

Abstract

Introduction: A reliable method to predict postoperative risks may improve surgical risks and ensure preventive precautions to reduce complication risks. American Society of Anesthesiologists (ASA) is a common method to determine surgical risk, but at first glance it appears to be insufficient to determine the risk of morbid obesity surgery. The greatest advantage of Obesity Surgery Mortality Risk Score (OS-MRS) is the use of five easily obtained clinical variables. A possible disadvantage is that it may only show mortality. It was reported that OS-MRS can be used for morbidity. However, there are inconsistent results. In this study, we aimed to compare the preoperative OS-MRS results with postoperative Clavien-Dindo for ASA III patients undergoing laparoscopic sleeve gastrectomy and to show the predictive power of the OS-MRS for morbidity in this group. Material-Method: The study retrospectively included patients who underwent laparoscopic sleeve gastrectomy for morbid obesity from 2014 to 2018. All patients had OS-MRS scores recorded as clinical protocol in their files. The morbidity within 90 days in files was assessed according to the Clavien-Dindo classification. Results: Values remaining under the curve may be used to interpret OS-MRS points (p < 0.05). The cutoff value for OS-MRS points according to complications was calculated as 1. OS-MRS points above 1 may be associated with complications. The variable of OS-MRS points may be used as a parameter for complication cutoff. However, as the area under the curve (AUC) was close to 0.5, it is necessary to question the reliability. Conclusion: OS-MRS may be used for mortality in laparoscopic sleeve gastrectomy; however, it is unreliable to determine morbidity.