Unplanned interventions following bariatric surgery: first cohort outcomes from the National Emergency Bariatric Surgery Audit (NEBSA)
In brief
Emergency bariatric surgery complications carry a 0.8% 30-day mortality rate
In a UK audit of 187 patients needing urgent treatment for bariatric-surgery complications, two deaths occurred (0.8% mortality) and 14% required intensive care. Most presented via the emergency department and 73% received follow-up, but care pathways and ICU thresholds varied widely, underscoring the need for standardized protocols and dedicated training.
- Journal
- International journal of surgery (London, England) (Q1)
- Published
- 11 May 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Arkeliana Tase, Fahad M Iqbal, Alan Askari, Matthew J Lee, Marianne Hollyman, Roxanna Zakeri, et al.
- PMID
- 42682315
- DOI
- 10.1097/JS9.0000000000005096
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 3 September 2026): Emergency bariatric surgery audit, 30‑day mortality 0.8%
Abstract
BACKGROUND: Despite the increasing volume of bariatric surgery, patterns of management following complications are poorly characterized in national datasets. We present the UK data collected by the National Emergency Bariatric Surgery Audit on patient characteristics following treatment for bariatric surgery complications, concentrating on 30-day mortality, complication severity, threshold for intensive care unit (ITU)/ high dependency unit (HDU) care, and postoperative follow-up. These data seek to inform the design of new clinical studies, support service development, and address surgical training requirements. METHODS: A prospective, multi-center audit was conducted across UK hospitals from October 2023 to March 2025. Adults presenting with bariatric surgery-related complications requiring urgent intervention were included. Demographics, index procedures, presentation details, and outcomes were collected using a standardized electronic tool. RESULTS: A total of 187 patients were included. The median age was 43 years, and 85.6% were female. The most common index procedures were sleeve gastrectomy (25.7%) and Roux-en-Y gastric bypass (31%). A total of 34.8% of patients had undergone surgery abroad. Emergency department attendance accounted for 72.2% of presentations. Emergency surgery was needed in 86.1% of cases, with two recorded deaths (0.8%). Additionally, 14% of patients were admitted to ITU. Follow-up was arranged for 73.3% of patients. Variation was noted in follow-up plans and the threshold for ITU/HDU care. CONCLUSION: Emergency bariatric surgery is a distinct and growing domain within acute surgical practice. This study highlights the urgent need for standardization of treatment pathways, targeted investment, training, and national collaboration to improve outcomes in the emergency treatment of bariatric complications. The data from this cohort can provide a stepping stone to better understanding the service, training, research, and funding needs of complex bariatric emergency services.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.