Complication rate inversely related to surgery volume; Center of Excellence status not a factor
TUESDAY, July 27 (HealthDay News) -- Serious complications associated with bariatric surgery are relatively low in Michigan patients, especially if their operations are performed by high-volume surgeons or in high-volume hospitals, regardless of whether the hospital is an accredited Center of Excellence (COE), according to research published in the July 28 issue of the Journal of the American Medical Association.
To assess complication rates and variability according to procedure type and volume as well as COE status, Nancy J.O. Birkmeyer, Ph.D., of the University of Michigan in Ann Arbor, and colleagues evaluated short-term morbidity in 15,275 patients undergoing one of three bariatric procedures across 25 hospitals involving 62 surgeons in Michigan from 2006 to 2009.
The researchers found perioperative complications, mainly wound problems and other minor issues, in 7.3 percent of the patients within 30 days of surgery. Gastric bypass rated highest for complications, followed by sleeve gastrectomy and laparoscopic adjustable banding (3.6, 2.2 and 0.9 percent, respectively), with mortality rates of 0.14, 0 and 0.04 percent of patients, respectively. Across hospitals, after adjustment for procedure mix and patient characteristics, the serious complication rate varied from 1.6 to 3.5 percent, and complication rates were lower in the hospitals and among surgeons with the highest procedure volume, but did not significantly differ for COE versus non-COE hospitals.
"The frequency of serious complications among patients undergoing bariatric surgery in Michigan was relatively low. Rates of serious complications are inversely associated with hospital and surgeon procedure volume, but unrelated to COE accreditation by professional organizations," the authors write.
One author is a member of the Ethicon Endo-Surgery Provider Advisory Council, and another author is employed part time by Blue Cross Blue Shield of Michigan, which provided funding for the study, as did Blue Care Network.
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