Background

Intragastric balloons (IGB) have emerged as a novel minimally invasive therapeutic modality for treatment of obesity, however, factors placing patients at risk for early reintervention are poorly understood.

Methods

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was queried to identify patients who underwent IGB between 2016 and 2017. Cohorts were stratified by need for a post-IGB procedural reintervention within 30-days. Patient and procedural demographics were compared using Mann-Whitney and Pearson’s χ2 tests. Multivariable logistic regression (MVR) analysis was performed adjusting for patient characteristics associated with reintervention at p<0.1.

Results

Of 2,910 IGB procedures identified, 125 (4.3%) patients required reintervention. On univariate analysis, patients requiring reintervention had increased median Body Mass Index (BMI) (36.8 vs 34.8; p<0.001) and were less likely to have had previous foregut surgery (PFS) (5.6% vs 20%, p<0.001). On MVR adjusting for age, race, BMI, gastroesophageal reflux, chronic obstructive pulmonary disease (COPD), hypertension, diabetes, chronic steroid use, and history of PFS, predictors of reintervention included: increased age (OR 1.02; 95% CI:[1.01-1.04]), chronic steroid use (OR 4.82; 95% CI:[2.03-11.47]), and history of COPD (OR 7.27; 95% CI:[1.77-29.81]). Increased BMI was not associated with risk of 30-day reintervention (OR 1.02; 95% CI:[0.99-1.04]).

Conclusions

Independent of patient BMI, risk factors for 30-day reintervention following IGB include increased age, chronic steroid use, and a history of COPD. Understanding patients at highest risk for reintervention may allow for improved patient selection and short-term outcomes for this novel treatment.