The prevalence of obesity continues to rise in Australia and New Zealand. Bariatric surgery is offered as a means of providing predictable and sustainable weight loss. A clinical quality registry began in 2012 to track the safety, efficacy and outcomes of bariatric surgery.
Aim:
To record the immediate, and to study longitudinally, the safety and efficacy of bariatric surgery in Australia and New Zealand, as well as track key health changes following bariatric surgery.
Methods:
Submission of data to the registry was done online or by hard copy. Data collected included patients’ demographics, height, weight, diabetes status and treatment, type of bariatric procedure, devices used, surgical complications, and mortality. Patients who did not opt out after receiving explanatory statements had their outcome measures recorded peri-operatively (20-90 days post-operation) and annually thereafter.
Results:
As of 30 June 2016, 16,577 bariatric procedures were recorded from 15,643 Australian patients. New Zealand surgeons were not able to contribute due to ethics in progress. The mean age of the patient cohort was 44.2 years and mostly female (79%). The death rate was 0.04%. In the perioperative period, defined adverse events (readmission to hospital, return to theatre or ICU admission) were recorded in 2.1% of primary procedures and 5.3% of revision procedures. Excess weight loss of 55.7% was reported at one year follow up, 51.2% at two years, and 51.8% at three years. Amongst patients with diabetes at baseline, 38% required no medication after one year and those requiring insulin dropped from 23% to 10%. However, this follow-up data field was under-reported.
Conclusion:
These initial data are promising, confirming the efficacy and safety of bariatric surgery at a community level in Australia. Increased participation rates will reduce the risk of bias and allow for more robust conclusions.