Research Article

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

Table 3

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

Preoperative variablesHVBH n = 1047
Weighted n = 5235
LVBH n = 4399
Weighted n = 21995
value unadjusted

Age (years, mean±SE)48.1 ± 0.648.5 ± 0.30.47
Length of stay (days, mean±SE)5.3 ± 0.24.9 ± 0.10.05
Median household income quartile for zip code2.2 ± 0.12.2 ± 0.00.49
Gender, female (%± SE)27.4 ± 1.430.0 ± 0.70.10
Renal failure (%± SE)1.8 ± 0.41.6 ± 0.20.58
Hypertension (%± SE)45.5 ± 1.644.6 ± 0.80.65
Chronic obstructive pulmonary dis. (%± SE)8.2 ± 0.99.0 ± 0.40.48
Diabetes mellitus type 2 (%± SE)10.4 ± 0.98.9 ± 0.40.12
Anemia (%± SE)0.67 ± 0.250.36 ± 0.090.17
Gastroesophageal reflux disease (%± SE)27.7 ± 1.523.1 ± 0.70.003
Chronic peptic ulcer disease (%± SE)0.76 ± 0.271.18 ± 0.160.24
Heart failure (%± SE)10.0 ± 1.08.2 ± 0.40.08
Hypothyroidism (%± SE)10.7 ± 1.011.6 ± 0.50.43
History of venous thromboembolism (%± SE)3.2 ± 0.62.7 ± 0.20.42
History of pulmonary embolism (%± SE)2.1 ± 0.41.7 ± 0.20.36
Nicotine dependence (%± SE)17.1 ± 1.215.7 ± 0.60.31
Obstructive sleep apnea (%± SE)23.4 ± 1.419.5 ± 0.60.009
Cholecystectomy volume (cases/hospital ± SE)54.9 ± 2.539.0 ± 0.9<0.0001

Postprocedure complicationsHVBHLVBH value unadjustedATE (95% CI) value adjusted
Shock (%± SE)0.19 ± 0.130.11 ± 0.050.53
Hemorrhage or hematoma (%± SE)0.10 ± 0.100.27 ± 0.080.29−0.20 (−0.39/−0.02)0.03
Cardiac arrest (%± SE)0.19 ± 0.130.05 ± 0.030.12−0.49 (−1.01/0.03)0.07
Bowel obstruction (%± SE)0.86 ± 0.281.14 ± 0.160.43−0.19 (−0.55/0.17)0.31
Enterotomy (%± SE)0.38 ± 0.190.48 ± 0.100.68−0.17 (−0.53/0.19)0.36
GI bleed (%± SE)0.19 ± 0.140.39 ± 0.090.33
Pulmonary failure (%± SE)1.2 ± 0.31.6 ± 0.20.33−0.43 (−1.23/0.37)0.29
Pneumonia (%± SE)0.19 ± 0.130.25 ± 0.070.72−0.15 (−0.39/0.08)0.20
Genitourinary complication (%± SE)0.19 ± 0.130.09 ± 0.040.38
Postoperative infection (%± SE)0.29 ± 0.160.43 ± 0.100.50−0.24 (−0.55/0.08)0.14
Wound disruption (%± SE)0.29 ± 0.160.27 ± 0.080.94−0.17 (−0.41/0.06)0.15
Venous thromboembolism (%± SE)0.10 ± 0.100.25 ± 0.070.34−0.17 (−0.41/0.07)0.17
Pulmonary embolism (%± SE)0.29 ± 0.160.30 ± 0.080.960.09 (−0.38/0.56)0.70
“Other” complications (%± SE)0.10 ± 0.100.16 ± 0.060.63
Death (%± SE)0.67 ± 0.250.41 ± 0.100.260.22 (−0.27/0.71)0.39
Patient had any complication (%± SE)3.82 ± 0.585.11 ± 0.340.08−1.88 (−3.17/−0.58)0.005

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