The Ability of Healthcare Professionals to Predict Patient Outcomes Following Bariatric Surgery

Introduction: Patients with obesity seeking bariatric surgery undergo an extensive evaluation by a multidisciplinary team of healthcare professionals' (HCPs) to assess patient compliance among other factors and determine their eligibility for surgery. However, the HCPs' assessments are not devoid of bias that may affect eligibility and preoperative decisions. This study aimed to investigate team members' ability to predict patient outcomes following bariatric surgery.

Materials and methods: HCPs and other clinic staff at an academic institution completed a survey on postoperative outcomes prediction of adult patients seeking bariatric surgery from 2019 to 2020. HCPs and staff predictions for weight loss at 6 mo and 1 y, 30-d complications, and comorbidity resolution were compared with actual patient outcomes. Linear and logistic regression models were used, adjusting for preoperative body mass index, American Society of Anesthesiologists classification, and procedure type.

Results: 1503 predictions on 618 patients were collected, of whom 293 underwent surgery with at least 6 mo of follow-up. On adjusted analysis, the predictions on weight loss were not associated with body mass index reduction at 6 mo or 1 y (1-y data available for 155 patients). However, HCPs accurately predicted the length of stay (LOS) (coeff = 0.24, 95% CI = 0.07-0.41) and comorbidity resolution (aOR = 1.68, 95% CI = 1.21-2.33), while clinic staff only predicted the LOS (coeff = 0.30, 95% CI = 0.08-0.53).

Conclusions: While HCPs predicted the resolution of comorbidities and LOS, their predictions failed to correlate with weight loss outcomes following bariatric surgery. Additionally, there was no association between predictions and 30-d complications, readmissions, or emergency department visits. The HCPs' perspectives during patients' preoperative supervised weight loss program, while important, should not bias the decision-making process, particularly proceeding with surgery.