Evidence map›Paper›PMID 40966179›Full record

ArticleObesity facts2026

Development and Statistical Validation of the Metabolic Surgery Indication Score: Standardized Procedure Selection in Metabolic and Bariatric Surgery.

Nadia De Falco, Panagiotis Lainas, Yitka Graham, Teresa Nutile, Giuseppe Signoriello, Simone Squillante, Vincenzo Bottino, Sonja Chiappetta

Abstract readValidation Study
In one paragraph

Article in Obesity facts, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Nadia De FalcoDepartment of General and Laparoscopic Surgery, Bariatric and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy.
Panagiotis LainasDepartment of Metabolic and Bariatric Surgery, Metropolitan Hospital, Athens, Greece, drlainas@gmail.com.
Yitka GrahamHelen McArdle Nursing and Care Research Institute, University of Sunderland, Sunderland, UK.
Teresa NutileInstitute of Genetics and Biophysics "A. Buzzati-Traverso", CNR, Naples, Italy.
Giuseppe SignorielloDepartment of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
Simone SquillanteDepartment of General Surgery, ASP Cosenza, Hospital of Paola-Cetraro, Paola, Italy.
Vincenzo BottinoDepartment of General and Laparoscopic Surgery, Bariatric and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy.
Sonja ChiappettaDepartment of General and Laparoscopic Surgery, Bariatric and Metabolic Surgery Unit, Ospedale Evangelico Betania, Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB) are two of the three most performed metabolic and bariatric surgery (MBS) procedures worldwide. Indication for the proper surgical procedure is based on the surgeon's choice, and no validated score for procedure selection exists. The aim of this study was to develop and validate a clinical score, which standardizes procedure selection in MBS.

methodsBased on the importance of obesity complications and comorbidities, we created a Metabolic Surgery Indication Score (MetSIS), including ten clinical and laboratory parameters to categorize the complex disease obesity with its comorbidities: age, sex, body mass index (BMI), obstructive sleep apnea syndrome (OSAS), hypertension, dyslipidemia, type 2 diabetes mellitus (T2DM), HbA1c, insulin therapy, and metabolic dysfunction-associated steatotic liver disease (MASLD). Minimum score was 0 points, and maximum 12 points. Retrospectively, data from all patients who underwent primary SG or OAGB in a 4-year period in our center of excellence for MBS were analyzed. Exclusion criteria included reflux disease (esophagitis ≥C next to LA classification) and/or the presence of hiatal hernia (≥3 cm) (since these patients undergo RYGB next to the internal protocol) and revisional bariatric surgery.

resultsFrom March 2019 to September 2023, 468 patients underwent SG (n = 363) or OAGB (n = 105) as primary bariatric procedure. Mean BMI was 42.1 kg/m2 (SG) and 48 kg/m2 (OAGB). Patients who underwent SG demonstrated lower MetSIS, while patients who underwent OAGB had a higher score (p < 0.001). The parameters BMI (p < 0.001), presence of OSAS associated with CPAP treatment (p < 0.001), hypertension (p < 0.001), T2DM (p < 0.001), insulin requirement (p = 0.001), and MASLD (p = 0.035) were found as statistically significant parameters which influenced procedure choice.

conclusionThe MetSIS is a simple and immediate score, which can be applied during decision-making of MBS procedure in routine clinical settings. Further studies are necessary to associate this score to the real metabolic outcome during long-term follow-up.

Indexed as

Bariatric SurgeryGastrectomyGastric BypassObesityObesity, MorbidAdultBody Mass IndexComorbidityDiabetes Mellitus, Type 2FemaleHumansMaleMiddle AgedPatient SelectionRetrospective StudiesSleep Apnea, ObstructiveBariatric and metabolic procedure selectionMetabolic surgeryOne anastomosis gastric bypassPrimary bariatric procedureProcedure selectionSleeve gastrectomy

Identifiers

PMID40966179
PMCPMC13046351

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