Key result
Higher BAR-HARM scores were strongly associated with increased 30-day complication rates, rising from 3.95% in patients with a score ≤2 to 79.97% in those with a score >4.
Why the study?
Does the BAR-HARM score correlate with complication rates in bariatric surgery patients?
Observational (n=197,141)
Yes
Does the BAR-HARM score correlate with complication rates in bariatric surgery patients?
The BAR-HARM score is a valid and inexpensive tool to measure the quality of bariatric surgery, strongly correlating with complication rates.
BAR-HARM score correlates with bariatric complications; supports validation as low-cost quality metric but leaves open prospective confirmation before practice adoption.
BACKGROUND: The HospitAl stay, Readmission, and Mortality rates (HARM) score is a quality indicator that is easily determined from routine administrative data. However, the HARM score has not yet been applied to patients undergoing bariatric surgery. OBJECTIVE: The aims of the present study were to adjust the HARM score to the bariatric population and to validate the ability of the modified HARM score to serve as an inexpensive tool to measure the quality of bariatric surgery. METHODS: A MBSAQIP 2015 PUF database was reviewed. For each discharge, a 1 to 10 score was calculated on the basis of length of stay (LOS), discharge status, and 30-day readmissions. We adjusted the LOS categories to the distribution of LOS in the MBSQIP database. The new LOS categories were used to calculate the modified HARM score, referred to as the BARiatric HARM (BAR-HARM) score. The association between HARM and BAR-HARM scores and complication rate was assessed. RESULTS: A total of 197,141 cases were evaluated: 98.8% were elective and 1.2% were emergent admissions. The mean individual patient BAR-HARM score was 1.75 ± 1.04 for elective cases, and 2.02 ± 1.45 for emergency cases. The complication rates for the respective BAR-HARM categories ≤ 2, > 2 to 3, > 3 to 4, and > 4 were 3.95, 27.53, 40.14, and 79.97% (p < 0.001). CONCLUSIONS: The quality of bariatric surgery can be reliably and validly assessed using the BAR-HARM score, which is a modification of the HARM score.
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Janik et al. (2018) conducted an observational in Bariatric surgery (n=197,141). BAR-HARM score > 4 vs. BAR-HARM score ≤ 2 was evaluated on 30-day complication rate (OR 97.082, 95% CI 89.368-105.463, p=<0.001). Higher BAR-HARM scores were strongly associated with increased 30-day complication rates, rising from 3.95% in patients with a score ≤2 to 79.97% in those with a score >4.
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