Rapid response teams (RRT) are designed to recognise deteriorating patients to prevent adverse events. Bariatric surgery patients are traditionally perceived as being of higher perioperative risk for deterioration compared to more familiar operations, such as laparoscopic cholecystectomy. The purpose of this study was to compare bariatric surgery with laparoscopic cholecystectomy utilising incidence of RRT activation as the measure for patient all-cause deterioration.
This observational study involved all elective laparoscopic cholecystectomy and bariatric surgery admissions over a five-year period (01/01/2014 – 31/12/2018) at a high-volume tertiary institution. Data for RRT were collected prospectively and cross-referenced by admission date and patient identity.
There were RRT activations in 25 (4%) of 596 admissions for bariatric surgery and 16 (1%) of 1438 admissions for laparoscopic cholecystectomy.
For bariatric surgery the mean age was 47, percentage of female patients 79.7% and ASA distribution of 2.9, 30.1, 63.7, 33.3 and 0 percent respectively for grades one to five.
For laparoscopic cholecystectomy the mean age was 48, percentage of female patients 73.6% and ASA distribution of 30.0, 52.9, 17.0, 1.1 and 0 percent respectively for grades one to five.
RRT activations are uncommon in elective admissions for laparoscopic cholecystectomy and bariatric surgery. The incidence of RRT is comparable between the two types of surgery and thus there should be a shift in perception of bariatric surgery from being considered high perioperative risk to one similar to the low-risk laparoscopic cholecystectomy. This is also in spite of there being a higher proportion of ASA 3 and 4 patients in the bariatric surgical cohort but otherwise typically of similar age and gender.