National Emergency Bariatric Surgical Audit (NEBSA): a protocol for a multi-center prospective study of unplanned interventions following emergency bariatric surgery.

Introduction: The advent of bariatric surgery as a widespread intervention is paralleled by comprehensive data capture in bariatric registries following elective surgery. However, significant challenges hinder tracking the incidence and nature of severe complications in the context of bariatric surgery. As the prevalence of bariatric procedures escalates, the establishment of a dedicated, prospective complication registry becomes imperative. Such an initiative would facilitate a nuanced understanding of bariatric surgical emergency (BSE) within the current healthcare milieu, enhance economic evaluations, elucidate long-term patient outcomes, and inform requisite adjustments in professional training. This study is designed to capture and assess the ramifications of emergency bariatric surgical practices within the United Kingdom.

Methods and analysis: We propose a prospective, multi-center, audit of emergency bariatric surgical activity in all UK hospitals. Eligible participants are those who undergo any intervention or procedure (surgical or endoscopic) to diagnose or treat BSE. Primary outcome measures will include hospital length of stay, rates of complications (Clavien-Dindo), and 30-D mortality. Secondary outcomes will assess the broader impacts and patterns of care, including variations in practice and resource utilization across the nation, rates of outpatient follow-up, and the frequency of subsequent procedures (surgical or endoscopic) post-BSE. Additionally, the study will investigate potential predictors for patients' choice between state-funded and self-pay bariatric surgery options, considering factors such as ethnicity and previous engagement with NHS-specialized weight loss pathways.

Ethics and dissemination: This study will be registered as clinical audit at each participating hospital. The protocol will be disseminated through the British Obesity and Metabolic Surgery Society network and using a targeted social media-based strategy in the UK.