S2242 Safety Profile of Intragastric Balloon Placement in Patients With Class III Obesity: An MBSAQIP Database Analysis From 2016-2023

Introduction: Intragastric balloon (IGB) therapy is a minimally invasive endoscopic intervention primarily utilized for weight reduction in patients with Class I and II obesity. While less frequently utilized in individuals with Class III obesity (BMI ≥40 kg/m²), IGB placement may be considered as a bridge to bariatric surgery or when surgery is contraindicated or declined. However, data regarding short-term postoperative outcomes in this higher-risk population remain limited. Therefore, this study aims to compare 30-day safety outcomes after IGB placement in patients with BMI ≥40 kg/m² versus BMI <40 kg/m². Methods: This was a retrospective cohort study of 4,555 patients undergoing primary IGB placement from 2016 to 2023 using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Revision or conversion procedures were excluded. Primary outcomes included 30-day rates of emergency department (ED) visits, readmissions, reoperations, interventions, and death. Patients were stratified by BMI ≥40 kg/m² and BMI <40 kg/m² for comparative analysis using multivariable logistic regression. IBM SPSS Statistics 29.0.2.0 was used and a P-value less than 0.05 was considered statistically significant for all analyses. Results: Patients with BMI ≥40 kg/m² were younger on average and more likely to be man and non-Hispanic Black. This group exhibited a higher prevalence of preoperative comorbidities, including diabetes, obstructive sleep apnea, hypertension, renal insufficiency, immunosuppressant use, previous thromboembolic events, and therapeutic anticoagulation use. Functional independence was marginally lower, while procedure length remained comparable between groups. No significant differences in 30-day postoperative outcomes, including ED visits, readmissions, reoperations, interventions, or death, were observed before or after adjustment for baseline differences. Conclusion: In this cohort undergoing IGB placement, patients with BMI ≥40 kg/m² exhibited a greater burden of comorbidities but demonstrated comparable short-term postoperative outcomes to those with BMI <40 kg/m². These findings support the short-term safety of IGB placement in patients with Class III obesity. AI Disclosure: ChatGPT was used to assist with language editing during the preparation of this abstract. The authors reviewed and approved the final content.