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Predictors of outcome after obesity surgery in New York state from 1991 to 2003

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Abstract

Background

This study aimed to examine hospital volume in New York state as a predictor of complications over 13 years.

Methods

Data from the New York state Statewide Planning and Research Cooperative Systems database were analyzed by diagnosis-related group, patient demographics, and outcomes. The institution data were analyzed on the basis of volume and logistic regression using chi-square analysis for predicting morbidity and mortality.

Results

From 1991 to 2003, 24,534 patients underwent bariatric surgery at 79 institutions. Case volume increased 36-fold in high-volume centers (HVCs), whereas the overall number of institutions doubled. The average mortality rate was 1.1% in low-volume centers (LVCs), 0.4% in medium-volume centers (MVCs), and 0.2% in HVCs. Whereas 12.4% of the LVC patients had postoperative anastomotic complications (PACs), only 9.7% had PACs in MVCs and only 7.3% had PACs in HVCs (p < 0.05). Furthermore, only 0.7% of the patients required postoperative reintubation (PRI) after surgery at HVCs, as compared with 1.5% at MVCs and 1.8% at LVCs (p < 0.05). Finally, 1.8% of the patients required blood transfusion of packed red blood cells at HVCs, whereas 2.4% required transfusion at MVCs and LVCs.

Conclusions

Experience correlates with fewer postoperative complications, including death, in bariatric centers in New York state.

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Authors and Affiliations

  1. Department of Surgery, New York Medical College, Grasslands Road, Munger Pavilion, Valhalla, NY, 10595, USA

    M. Parker, M. Loewen, T. Sullivan, E. Yatco, T. Cerabona, J. A. Savino & A. Kaul

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  1. M. Parker
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  2. M. Loewen
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  3. T. Sullivan
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  4. E. Yatco
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  5. T. Cerabona
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  6. J. A. Savino
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  7. A. Kaul
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Corresponding author

Correspondence to A. Kaul.

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Parker, M., Loewen, M., Sullivan, T. et al. Predictors of outcome after obesity surgery in New York state from 1991 to 2003. Surg Endosc 21, 1482–1486 (2007). https://doi.org/10.1007/s00464-007-9245-5

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  • DOI: https://doi.org/10.1007/s00464-007-9245-5

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