A numerical scale to assess the outcomes of metabolic/bariatric surgery (NOMS)

Maciej Michalik; Maciej Bobowicz; Henry Buchwald

doi:10.5114/wiitm.2015.54085

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abstract:

Original paper

A numerical scale to assess the outcomes of metabolic/bariatric surgery (NOMS)

Maciej Michalik

,

Maciej Bobowicz

,

Henry Buchwald

Videosurgery Miniinv 2015; 10 (3): 359–362

DOI: https://doi.org/10.5114/wiitm.2015.54085

Online publish date: 2015/09/14

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Introduction: Absent today is a simple numerical system of outcomes assessment that recognizes that bariatric surgery is metabolic surgery and incorporates weight loss, hypertension control, and type 2 diabetes control.

Aim: To introduce a simple, new Numerical Scale to Assess the Outcomes of Metabolic Surgery (NOMS).

Material and methods: For the stratification of weight outcomes, we used the percentage excess weight loss (%EWL); for hypertension, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) combined with medication usage; and for type 2 diabetes, the hemoglobin A_1c (HbA_1c) value combined with medication usage.

Results: Utilizing the guidelines of the American Diabetes Association, the Working Group of the European Society of Hypertension, the European Society of Cardiology, and the American College of Cardiology/American Heart Association, we propose for %EWL: W1 ≥ 50, W2 > 25 and < 50, and W3 ≤ 25; for hypertension H1 SBP/DPB < 140/90 mm Hg on no medication, H2 SBP/DBP ≥ 140/90 mm Hg with improvement of SBP or possible reduction of antihypertensive medication, and H3 no change or SBP higher than before surgery; for diabetes mellitus D1 HbA_1c ≤ 7% and no medication, D2 HbA_1c > 7% with a decrease of the HbA_1c level or possible reduction of medication, D3 no change in HbA_1c or HbA_1c higher than before surgery. Designations of H0 and D0 are given if hypertension or diabetes was not present before surgery. Patient examples for numerical scores are provided.

Conclusions: The introduction of our numerical scale (NOMS) can be of benefit in metabolic/bariatric outcomes assessment; communications among metabolic/bariatric surgery centers, physicians, and patients; and for more precise reporting in the evidence-based literature.

keywords:

A numerical scale to assess the outcomes of metabolic/bariatric surgery (NOMS)

Maciej Michalik , Maciej Bobowicz , Henry Buchwald

numerical system, outcomes assessment, metabolic surgery, bariatric surgery, diabetes, comorbidities

Maciej Michalik

,

Maciej Bobowicz

,

Henry Buchwald