Bariatric surgery: low mortality at a high-volume center

Area of Science:

• Bariatric Surgery
• Surgical Outcomes
• Health Services Research

Background:

• Accreditation programs by the American Society of Bariatric Surgery and American College of Surgeons emphasize high-volume centers for bariatric surgery.
• These programs hypothesize that concentrating weight loss surgeries in specialized centers reduces mortality and improves patient outcomes.

Purpose of the Study:

• To determine the in-hospital mortality rate for bariatric operations performed at a high-volume bariatric surgery center.
• To analyze factors influencing length of stay and mortality in bariatric surgery patients.

Main Methods:

• Retrospective review of 5,365 weight loss surgeries (WLS) performed at Hackensack University Medical Center from 1998 to June 2006.
• Data collected from electronic medical records, including patient demographics, surgical procedures, operating room time, and length of stay.
• Statistical analysis using logistic regression to identify predictors of length of stay and in-hospital mortality.

Main Results:

• A total of 5,365 WLS procedures were performed, including open vertical banded gastroplasty-Roux en Y gastric bypass (VBG-RYGB), laparoscopic Roux en Y gastric bypass (LRYGB), and laparoscopic adjustable gastric banding (LAGB).
• The overall in-hospital mortality rate was 0.13% (7 out of 5,365 patients).
• Mortality rates varied by procedure: 0.19% for VBG-RYGB, 0.14% for LRYGB, and 0% for LAGB. Median length of stay was 3 days for VBG-RYGB, 2 days for LRYGB, and 1 day for LAGB.

Conclusions:

• Hackensack University Medical Center, an accredited high-volume bariatric surgery center, achieved a low in-hospital mortality of 0.13% for 5,365 weight loss operations.
• The findings support the hypothesis that high-volume centers are associated with reduced mortality in bariatric surgery.
• Patient characteristics did not significantly differ between those who died and the overall patient cohort.