Surgical volume impacts bariatric surgery mortality

In a study by Hollenbeak CS, et al the number of cases done per year by a surgeon and a hospital affected death rates.(1)  They performed a population-based study examining the effect of bariatric surgery volume on mortality in Pennsylvania.  “Between 1999 and 2003, 14,716 patients having gastric bypass surgery in Pennsylvania hospitals were identified from the Pennsylvania Health Care Cost Containment Council database. Individual surgeons and hospitals were stratified as high (> 100 cases/yr), medium (50-100 cases/yr), or low volume (< 50 cases/yr). The relationship between surgeon and hospital volume on length of stay (LOS), in-hospital, and 30-day mortality were examined, adjusting for age, gender, ethnicity, payor, and MedisGroups Admission Severity Group (ASG) score.”

They found that hospital and surgeon volume were associated with increased in-hospital and 30-day mortality.

“Controlling for other factors, patients treated by low- and medium-volume surgeons (OR 3.7, P = .002; OR 2.8, P = .015) and hospitals (OR 2.3, P = .01; OR 2.44, P = .017) had increased odds of 30-day mortality versus high-volume surgeons and hospitals. LOS was significantly shorter at high-volume hospitals as well.”

That is they found that low volume surgeons and hospitals had death rate with odds ratios 2 to 4 times higher than the death rates in the hands of high volume experienced surgeons and hospitals!

Dr.s Rutledge and Peraglie performed over 500 MGBs last year putting them in the category of some of the highest volume bariatric surgeons in the world.

1. Surgical volume impacts bariatric surgery mortality: a case for centers of excellence. Hollenbeak CS, Rogers AM, Barrus B, Wadiwala I, Cooney RN. Surgery. 2008 Nov;144(5):736-43. Epub 2008 Jul 21.  PMID: 19081015 [PubMed – indexed for MEDLINE]

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