Research Article

The Effect of Bariatric Surgery Volume on General Surgery Outcomes for Morbidly Obese Patients

Table 2

Preoperative comorbidities and postoperative complications of patients with morbid obesity undergoing elective laparoscopic cholecystectomy.

Preoperative variablesHVBH n = 942
Weighted n = 4710
LVBH n = 823
Weighted n = 4115
value unadjusted

Age (years, mean±SE)47.9 ± 0.651.0 ± 0.5<0.0001
Length of stay (days, mean±SE)3.3 ± .024.1 ± 0.2<0.0001
Median household income quartile for zip code2.5 ± 0.052.4 ± 0.040.05
Gender, female (% ± SE)75.5 ± 1.571.5 ± 1.40.06
Renal failure (% ± SE)0.73 ± 0.301.17 ± 0.330.34
Hypertension (% ± SE)53.3 ± 1.652.4 ± 1.50.68
Chronic obstructive pulmonary dis. (%± SE)5.2 ± 0.87.9 ± 0.90.03
Diabetes mellitus type 2 (%± SE)9.5 ± 1.011.7 ± 1.00.12
Anemia (%± SE)1.94 ± 0.710.74 ± 0.270.05
Gastroesophageal reflux disease (%± SE)39.5 ± 2.136.9 ± 1.90.38
Chronic peptic ulcer disease (%± SE)0.49 ± 0.300.74 ± 0.260.54
Heart failure (%± SE)4.1 ± 0.76.8 ± 0.80.01
Hypothyroidism (%± SE)11.5 ± 1.012.5 ± 1.00.49
History of venous thromboembolism (%± SE)3.7 ± 0.82.6 ± 0.50.19
History of pulmonary embolism (%± SE)2.3 ± 0.51.6 ± 0.40.25
Nicotine dependence (%± SE)21.4 ± 2.119.0 ± 1.30.30
Obstructive sleep apnea (%± SE)42.9 ± 3.633.7 ± 1.60.01
Cholecystectomy volume (cases/hospital ± SE)62.2 ± 8.140.4 ± 1.2<0.00

Postprocedure complicationsHVBHLVBH value unadjustedATE (95% CI) value adjusted
Shock (% ± SE)0.24 ± 0.170.42 ± 0.210.52
Hemorrhage or hematoma (% ± SE)0.49 ± 0.220.42 ± 0.210.84
Bowel obstruction (%± SE)1.22 ± 0.391.91 ± 0.450.25−0.50 (−1.57/0.58)0.36
Enterotomy (%± SE)0.73 ± 0.300.64 ± 0.240.810.37 (−0.35/1.10)0.32
GI bleed (%± SE)0.49 ± 0.250.85 ± 0.280.34−0.33 (−1.10/0.43)0.39
Pulmonary insufficiency (%± SE)0.12 ± 0.120.42 ± 0.180.22
Pulmonary failure (%± SE)0.85 ± 0.304.14 ± 0.67<0.0001−3.27 (−4.8/−1.73)<0.0001
Pneumonia (%± SE)0.61 ± 0.280.42 ± 0.180.57
Genitourinary complication (%± SE)0.24 ± 0.170.21 ± 0.150.89
Postoperative infection (%± SE)0.85 ± 0.310.85 ± 0.301.000.18 (−0.90/1.26)0.74
Wound complication (%± SE)0.12 ± 0.120.11 ± 0.110.92
Venous thromboembolism (%± SE)0.12 ± 0.120.42 ± 0.210.23
Pulmonary embolism (%± SE)0.36 ± 0.210.32 ± 0.180.87
“Other” complications (%± SE)0.12 ± 0.120.11 ± 0.110.92
death (%± SE)0.24 ± 0.170.96 ± 0.320.06−0.65 (−1.30/0.01)0.05
Patient had any complication (%± SE)6.0 ± 0.99.5 ± 1.00.01−2.67 (−5.25/−0.09)0.04

HVBH: high volume bariatric hospital; LVBH: low volume bariatric hospital; ATE: average treatment effect.