Adoption of the Polish Bariatric and Metabolic Surgery Care Standards: a nationwide survey.

Abstract

Introduction: Metabolic and bariatric surgery (MBS) is the most effective treatment for severe obesity, providing substantial weight loss and improvement in obesity-related comorbidities. In 2020, the MBS Chapter of the Association of Polish Surgeons issued the Bariatric and Metabolic Surgery Care Standards to guide patient management.

Aim: The aim of the study was to asses implementation of the standards in Polish surgical departments and identify factors associated with better compliance.

Materials and methods: An online survey was distributed between August and December 2022 to 46 Polish surgical departments performing MBS. The survey included 62 questions covering general center characteristics, and pre-, peri-, and postoperative care. Descriptive statistics summarized the center characteristics and linear regression models analyzed the factors influencing compliance.

Results: Thirty-six centers completed the survey, with a mean (SD) compliance score of 86.8% (9%) (29.5 of 34 criteria), and individual scores ranging from 70.6% to 100%. As many as 66.7% of the centers answered at least 80% of the questions. The areas with compliance below 80% included availability of adapted radiology facilities, constant availability of emergency radiology diagnostics, screening for metabolic markers, assessment of obstructive sleep apnea risk, obtaining patient declaration of abstaining from smoking, providing dates for at least 1 dietary consultation upon discharge, requiring at least 2 consultations with an experienced dietician, and employing a surgeon with bariatric certificate of excellence. Significant predictors of better compliance included the number of surgeons performing MBS and participation in the KOS-BAR program (a program of complex specialist care over patient undergoing bariatric surgery).

Conclusions: The Bariatric and Metabolic Surgery Care Standards are moderately well adopted by Polish surgical departments, with improvements needed in specific areas. Unifying the standards may enhance patient outcomes.