The Cardiovascular
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Obesity Surgery Mortality Risk Score (OS-MRS)

Estimates perioperative mortality risk before bariatric (gastric bypass) surgery.

Obesity Surgery Mortality Risk Score (OS-MRS)
BMI ≥50 kg/m²
Male sex
Hypertension
Known risk factor for pulmonary embolism
Prior venous thromboembolism, IVC filter in place, hypoventilation syndrome/obstructive sleep apnea, or pulmonary hypertension.
Age ≥45 years
Result0 points

Class A risk group; reported perioperative mortality approximately ~0.2 %.

Risk class
Class A
Reported mortality
~0.2 %

When to use

  • Preoperative risk stratification before Roux-en-Y gastric bypass or other bariatric procedures.

Formula

One point each: BMI ≥50, male sex, hypertension, known PE risk factor, age ≥45. Class A 0–1, Class B 2–3, Class C 4–5.

Pearls and pitfalls

  • Derived and validated in gastric bypass cohorts; applicability to other bariatric procedures (e.g. sleeve gastrectomy) is less well studied.

References

  1. DeMaria EJ, et al. Ann Surg. 2007;246(4):578-82; discussion 583-4.
  2. DeMaria EJ, et al. Surg Obes Relat Dis. 2007;3(2):134-40 (original derivation).