Research Article

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

Table 4

Preoperative comorbidities and postoperative complications of patients with morbid obesity undergoing elective ventral hernia repair.

Preoperative variablesHVBH n = 514
Weighted n = 2570
LVBH n = 1130
Weighted n = 5650
value unadjusted

Age (years, mean±SE)54.8 ± 0.555.89 ± 0.40.08
Length of stay (days, mean±SE)5.1 ± 0.35.8 ± 0.30.17
Median household income quartile for zip code2.3 ± 0.052.3 ± 0.030.80
Gender, female (%± SE)72.2 ± 2.271.7 ± 1.40.87
Renal failure (%± SE)0.39 ± 0.281.06 ± 0.300.17
Hypertension (%± SE)57.4 ± 2.155.3 ± 1.50.42
Chronic obstructive pulmonary dis. (%± SE)13.0 ± 1.413.5 ± 1.00.77
Diabetes mellitus type 2 (%± SE)10.9 ± 1.411.2 ± 1.00.88
Anemia (%± SE)0.58 ± 0.340.97 ± 0.280.42
Gastroesophageal reflux disease (%± SE)35.2 ± 2.329.6 ± 1.40.03
Chronic peptic ulcer disease (%± SE)1.56 ± 0.590.44 ± 0.200.02
Heart failure (%± SE)5.8 ± 1.06.2 ± 0.70.78
Hypothyroidism (%± SE)15.0 ± 1.514.7 ± 1.00.87
History of venous thromboembolism (%± SE)6.4 ± 1.14.3 ± 0.60.07
History of pulmonary embolism (%± SE)6.4 ± 1.02.7 ± 0.50.0003
Nicotine dependence (%± SE)25.7 ± 2.018.9 ± 1.10.002
Obstructive sleep apnea (%± SE)38.5 ± 2.230.1 ± 1.30.001
Ventral hernia volume (cases/hospital ± SE)22.4 ± 2.213.2 ± 0.6<0.0001

Postprocedure complicationsHVBHLVBH value unadjustedATE (95% CI) value adjusted
Shock (%± SE)0.97 ± 0.630.27 ± 0.150.11
Bowel obstruction (%± SE)3.3 ± 0.94.5 ± 0.60.28−1.08 (−3.03/0.88)0.30
Enterotomy (%± SE)1.17 ± 0.460.97 ± 0.280.710.12 (−0.93/1.17)0.82
GI bleed (%± SE)0.39 ± 0.270.53 ± 0.200.69
Pulmonary insufficiency (%± SE)0.78 ± 0.380.27 ± 0.150.13
Pulmonary failure (%± SE)1.6 ± 0.54.7 ± 0.70.002−3.80 (−5.55/−2.04)<0.0001
Pneumonia (%± SE)0.78 ± 0.390.97 ± 0.290.700.01 (−1.06/1.07)0.99
Genitourinary complication (%± SE)0.19 ± 0.190.27 ± 0.150.79
Postoperative infection (%± SE)1.8 ± 0.62.5 ± 0.50.37−0.71 (−2.48/1.07)0.44
Wound complication (%± SE)0.58 ± 0.270.35 ± 0.180.45−0.35 (−1.84/1.14)0.64
Venous thromboembolism (%± SE)0.78 ± 0.380.44 ± 0.200.39
Pulmonary embolism (%± SE)1.17 ± 0.550.35 ± 0.170.060.77 (−0.47/2.00)0.22
“Other” complications (%± SE)0.19 ± 0.190.44 ± 0.200.44−0.39 (−1.12/0.34)0.29
Death (%± SE)0.58 ± 0.340.89 ± 0.280.52−4.91 (−8.68/−1.15)0.01
Patient had any complication (%± SE)12.3 ± 1.516.4 ± 1.10.03

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