Influence of checklist management model on postoperative complications and hospitalization time after metabolic and bariatric surgery

Abstract

Introduction: Metabolic and bariatric surgery (MBS) is associated with various postoperative complications and extended hospital stays. Standardized management protocols may enhance patient outcomes.

Aim: This study aimed to evaluate the impact of a checklist-based management protocol on postoperative recovery, length of hospital stay (LOS) and complications in patients undergoing laparoscopic MBS.

Materials and methods: A retrospective analysis was conducted on 209 patients who underwent laparoscopic MBS from December 2021 to December 2022. Patients were divided into two groups based on the perioperative management protocol: the control group (n = 97) received standard care, while the observational group (n = 112) received checklist-based management after protocol implementation. Primary outcomes included LOS, time to first flatus, and time to first mobilization. Secondary outcomes included postoperative complications classified by Clavien-Dindo grade, postoperative nausea and vomiting (PONV), and analgesic consumption. Health literacy and self-efficacy were assessed using the Newest Vital Sign (NVS) and Self-Rated Abilities for Health Practices (SRAHP) scale.

Results: The observational group demonstrated shorter LOS (median 4.0 vs. 6.0 days, P <0.001), earlier first flatus, and earlier first mobilization compared to the control group. The total complication rate was lower in the observational group (4.46% vs. 16.49%, P = 0.004). The observational group also showed lower incidence of PONV and reduced analgesic consumption. There were no differences in NVS or SRAHP scores between groups before management (P >0.05), but post-management, the observational group had higher scores (P <0.05).

Conclusions: Checklist-based perioperative management was associated with improved postoperative recovery, reduced complications, and enhanced health literacy and self-efficacy in patients undergoing MBS.