Research Article
The Effect of Bariatric Surgery Volume on General Surgery Outcomes for Morbidly Obese Patients
Table 5
Preoperative comorbidities and postoperative complications of patients with morbid obesity undergoing nonelective ventral hernia repair.
| Preoperative variables | HVBH n = 314 Weighted n = 1570 | LVBH n = 1143 Weighted n = 5715 | value unadjusted | | |
| Age (years, mean ± SE) | 55.5 ± 0.7 | 56.4 ± 0.4 | 0.27 | | | Length of stay (days, mean) | 8.0 ± 0.6 | 7.7 ± 0.3 | 0.56 | | | Median household income quartile for zip code | 2.2 ± 0.1 | 2.2 ± 0.0 | 0.96 | | | Gender, female (%± SE) | 74.5 ± 2.4 | 70.1 ± 1.3 | 0.12 | | | Renal failure (%± SE) | 0.96 ± 0.6 | 1.4 ± 0.4 | 0.54 | | | Hypertension (%± SE) | 57.3 ± 3.0 | 58.4 ± 1.4 | 0.75 | | | Chronic obstructive pulmonary dis. (%± SE) | 17.8 ± 2.2 | 15.3 ± 1.0 | 0.29 | | | Diabetes mellitus type 2 (%± SE) | 12.7 ± 1.9 | 11.7 ± 0.9 | 0.63 | | | Anemia (%± SE) | 0.32 ± 0.32 | 0.79 ± 0.26 | 0.37 | | | Gastroesophageal reflux disease (%± SE) | 27.4 ± 2.6 | 22.9 ± 1.2 | 0.11 | | | Chronic peptic ulcer disease (%± SE) | 0.96 ± 0.55 | 0.61 ± 0.23 | 0.51 | | | Heart failure (%± SE) | 13.4 ± 2.0 | 12.7 ± 1.0 | 0.75 | | | Hypothyroidism (%± SE) | 14.6 ± 2.0 | 15.5 ± 1.1 | 0.72 | | | History of venous thromboembolism (%± SE) | 5.7 ± 1.2 | 4.8 ± 0.6 | 0.48 | | | History of pulmonary embolism (%± SE) | 5.7 ± 1.4 | 3.1 ± 0.5 | 0.03 | | | Nicotine dependence (%± SE) | 21.7 ± 2.5 | 16.1 ± 1.1 | 0.03 | | | Obstructive sleep apnea (%± SE) | 35.7 ± 2.7 | 30.1 ± 1.1 | 0.06 | | | Ventral hernia volume (cases/hospital ± SE) | 20.9 ± 1.8 | 10.8 ± 0.4 | <0.0001 | | |
| Postprocedure complications | HVBH | LVBH | value unadjusted | ATE (95% CI) | value adjusted | Shock (%± SE) | 0.64 ± 0.32 | 0.44 ± 0.17 | 0.56 | — | — | Cardiac arrest (%± SE) | 0.32 ± 0.32 | 0.26 ± 0.15 | 0.87 | — | — | Bowel obstruction (%± SE) | 4.1 ± 1.2 | 5.5 ± 0.7 | 0.35 | −0.79 (−3.80/2.23) | 0.61 | Enterotomy (%± SE) | 0.32 ± 0.32 | 0.79 ± 0.26 | 0.37 | −0.45 (−1.21/0.31) | 0.24 | GI bleed (%± SE) | 0.96 ± 0.55 | 0.96 ± 0.29 | 0.99 | −0.41 (−1.33/0.52) | 0.39 | Pulmonary insufficiency (%± SE) | 0.64 ± 0.45 | 0.26 ± 0.15 | 0.31 | — | — | Pulmonary failure (%± SE) | 4.1 ± 1.1 | 4.6 ± 0.6 | 0.70 | −0.08 (−2.81/2.66) | 0.96 | Pneumonia (%± SE) | 0.96 ± 0.55 | 0.61 ± 0.23 | 0.52 | 0.92 (−0.83/2.67) | 0.30 | Postoperative infection (%± SE) | 2.6 ± 0.9 | 3.3 ± 0.5 | 0.47 | −1.72 (−3.49/0.06) | 0.06 | Wound complication (%± SE) | 0.32 ± 0.32 | 0.09 ± 0.09 | 0.33 | −0.83 (−2.94/1.27) | 0.44 | Venous thromboembolism (%± SE) | 1.59 ± 0.70 | 0.96 ± 0.27 | 0.33 | 0.15 (−1.04/1.35) | 0.80 | Pulmonary embolism (%± SE) | 1.9 ± 0.8 | 1.5 ± 0.4 | 0.59 | −0.50 (−1.74/0.75) | 0.43 | Death (%± SE) | 0.32 ± 0.32 | 1.66 ± 0.37 | 0.07 | −1.15 (−2.18/−0.12) | 0.03 | Patient had any complication (%± SE) | 17.8 ± 2.1 | 17.8 ± 1.1 | 0.98 | −2.49 (−7.36/2.39) | 0.32 |
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HVBH: high volume bariatric hospital; LVBH: low volume bariatric hospital; ATE: average treatment effect.
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