High MELD 3.0 score is not an absolute contraindication to bariatric surgery.

J Alford Flippin, Shuqi Kang, Rana Omer Farman, Jasmin Patel, Faran Bokhari

Abstract read

In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

J Alford FlippinTrauma Surgery Department, OSF HealthCare Saint Francis Medical Center, 530 NE Glen Oak Avenue, North Bldg 3674, Peoria, IL, 61637, USA. jflippin@uic.edu.

Shuqi KangUniversity of Illinois College of Medicine, Peoria, USA.ORCID http://orcid.org/0000-0002-9566-9131

Rana Omer FarmanTrauma Surgery Department, OSF HealthCare Saint Francis Medical Center, 530 NE Glen Oak Avenue, North Bldg 3674, Peoria, IL, 61637, USA.

Jasmin PatelTrauma Surgery Department, OSF HealthCare Saint Francis Medical Center, 530 NE Glen Oak Avenue, North Bldg 3674, Peoria, IL, 61637, USA.

Faran BokhariTrauma Surgery Department, OSF HealthCare Saint Francis Medical Center, 530 NE Glen Oak Avenue, North Bldg 3674, Peoria, IL, 61637, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMELD 3.0 is a composite score used to predict mortality due to liver disease. Obesity is increasingly linked to liver disease and cirrhosis. Bariatric surgery is the most effective and durable method of managing morbid obesity and significantly improves many associated comorbid conditions, yet it is not without risk. Determining a reasonable risk profile for bariatric surgery is a complex decision made more difficult by lack of data regarding morbidity and mortality.

methodsWe used data from the National Surgical Quality Improvement Program (NSQIP) from 2017-2019 to 2021-2022. Patients who underwent Roux-en-Y gastric bypass or sleeve gastrectomy were included. Each patient's MELD 3.0 score was calculated. The primary outcome was mortality, calculated at each MELD 3.0 score. A line of best fit was constructed and used to calculate expected mortality rates for each MELD 3.0.

resultsWe identified 17,866 patients. Absolute observed mortality rates remained under 1% up to a MELD 3.0 of 18. Additionally, 167 patients with a MELD 3.0 greater than 20 were identified with only 1 mortality. The line of best fit showed an r

conclusionOur data suggests that there are specific patients with seemingly prohibitive MELD 3.0 scores who are able to safely undergo bariatric surgery. A high MELD 3.0 score is not an absolute contraindication for bariatric surgery. Further research exploring safe patient selection criteria could allow bariatric surgeons to identify a group of patients that had previously been thought too high-risk for bariatric surgery, but who could benefit immensely from the weight loss and improvement in comorbid conditions that bariatric surgery provides.

Indexed as

Bariatric SurgeryEnd Stage Liver DiseaseObesity, MorbidAdultContraindications, ProcedureFemaleGastrectomyGastric BypassHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentSeverity of Illness IndexMELD 3.0Obesity associated liver diseasePreoperative risk assessmentRoux-en-Y gastric bypassSleeve gastrectomy

Identifiers

PMID40770512

DOI10.1007/s00464-025-11940-w

PMCPMC12500746

What OpenQuestion holds

Textmetadata

LicenceCC BY

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.