• Rana M Higgins, Melissa Helm, Jon C Gould, and Tammy L Kindel.
• Department of Surgery, Division of General Surgery Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: rhiggins@mcw.edu.
• Surg Obes Relat Dis. 2018 Jun 1; 14 (6): 842-848.

BackgroundPreoperative immobility in general surgery patients has been associated with an increased risk of postoperative complications. It is unknown if immobility affects bariatric surgery outcomes.ObjectivesThe aim of this study was to determine the impact of immobility on 30-day postoperative bariatric surgery outcomes.SettingThis study took place at a university hospital in the United States.MethodsThe Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 2015 data set was queried for primary minimally invasive bariatric procedures. Preoperative immobility was defined as limited ambulation most or all the time. Logistic regression analysis was performed to determine if immobile patients are at increased risk (odds ratio [OR]) for 30-day complications.ResultsThere were 148,710 primary minimally invasive bariatric procedures in 2015. Immobile patients had an increased risk of mortality (OR 4.59, P<.001) and greater operative times, length of stay, reoperation rates, and readmissions. Immobile patients had a greater risk of multiple complications, including acute renal failure (OR 6.42, P<.001), pulmonary embolism (OR 2.44, P = .01), cardiac arrest (OR 2.81, P = .05), and septic shock (OR 2.78, P = .02). Regardless of procedure type, immobile patients had a higher incidence of perioperative morbidity compared with ambulatory patients.ConclusionsThis study is the first to specifically assess the impact of immobility on 30-day bariatric surgery outcomes. Immobile patients have a significantly increased risk of morbidity and mortality. This study provides an opportunity for the development of multiple quality initiatives to improve the safety and perioperative complication profile for immobile patients undergoing bariatric surgery.Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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