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Is bariatric surgery safe in academic centers?
Jose Lopez1, Jimmy Sung, Wayne Anderson
1Department of Surgery, University of South Florida, Tampa 33601, USA.
The American Surgeon
|October 3, 2002
Summary
Bariatric surgery outcomes are similar for high-risk patients regardless of surgeon affiliation. Academic surgeons perform more high-risk cases, leading to higher overall complication rates but comparable results in complex procedures.
Area of Science:
- Surgical Outcomes
- Health Services Research
Background:
- Contemporary outcomes of bariatric surgery require definition.
- Surgeon caseload and affiliation may influence surgical outcomes.
Purpose of the Study:
- To document bariatric surgery outcomes based on surgeon caseload and affiliation.
- To compare academic versus community-based surgeon performance.
Main Methods:
- Analysis of prospectively collected Florida-wide hospital discharge data from 1999.
- Comparison of outcomes (complications, length of stay, charges) between high-volume and low-volume surgeons, and academic versus community-based centers.
Main Results:
- High-volume surgeons ( >2 operations/month) performed 764 operations.
- Academic surgeons had higher complication rates (14% vs 7%), longer stays, and higher charges, but operated on more high-risk patients (36% vs 16%).
- In high-risk patients, outcomes (complications, length of stay, charges) were similar between academic and community-based surgeons.
Conclusions:
- Bariatric surgery outcomes in high-risk patients are comparable between academic and community-based surgeons.
- Academic surgeons disproportionately manage high-risk patients, contributing to their higher overall complication rates.
- Prospective data collection offers accurate insights into surgical outcomes, influencing practice.