Risk factors for postoperative bleeding in bariatric surgery

Background: Postoperative bleeding remains a relatively common complication following bariatric surgery and may lead to morbidity and even mortality. Objective: To develop a prediction model to identify patients at risk for postoperative bleeding. Setting: Rode Kruis Ziekenhuis, Beverwijk, the Netherlands. Based on Dutch nationwide obesity audit data. Methods: Patients undergoing primary bariatric surgery were selected from January 2015 to December 2020 from the Dutch Audit for Treatment of Obesity. The primary outcome was postoperative bleeding within 30 days. Assessed predictors included patient factors and operative data. A prediction model was developed using backward stepwise logistic regression. Internal validation was performed using bootstrapping techniques. Results: A total of 59,055 patients were included; 13,399 underwent a sleeve gastrectomy, and 45,656 underwent a gastric bypass procedure. Postoperative bleeding occurred in 1.5%. The following predictors were identified: male patients (odds ratio [OR] = 1.40; 95% confidence interval [CI]: 1.21–1.63), patients >45 years of age (OR = 1.50; 95% CI: 1.29–1.76), body mass index