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

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