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

Table 6

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

Preoperative variables	HVBH n = 205; Weighted n = 1025	LVBH n = 870; Weighted n = 4350	value unadjusted
Age (years, mean ± SE)	45.6 ± 1.3	44.4 ± 0.6	0.34
Length of stay (days, mean ± SE)	4.8 ± 0.6	3.9 ± 0.1	0.02
Median household income quartile for zip code	2.2 ± 0.1	2.3 ± 0.0	0.05
Gender, female (%± SE)	40.5 ± 3.5	40.1 ± 1.6	0.92
Renal failure (%± SE)	1.5 ± 0.8	1.4 ± 0.4	0.93
Hypertension (%± SE)	42.0 ± 3.6	41.0 ± 1.6	0.82
Chronic obstructive pulmonary dis. (%± SE)	8.3 ± 2.0	7.2 ± 0.9	0.61
Diabetes mellitus type 2 (%± SE)	9.8 ± 2.1	9.5 ± 1.0	0.92
Gastroesophageal reflux disease (%± SE)	18.0 ± 2.7	15.5 ± 1.2	0.37
Heart failure (%± SE)	3.9 ± 1.2	5.8 ± 0.8	0.26
Hypothyroidism (%± SE)	11.7 ± 2.2	8.7 ± 0.9	0.19
History of venous thromboembolism (%± SE)	1.5 ± 0.8	1.3 ± 0.4	0.82
History of pulmonary embolism (%± SE)	1.0 ± 0.7	1.2 ± 0.4	0.83
Nicotine dependence (%± SE)	17.1 ± 2.8	13.2 ± 1.1	0.16
Obstructive sleep apnea (%± SE)	22.9 ± 3.0	19.7 ± 1.4	0.30
Appendectomy volume (cases/hospital ± SE)	23.1 ± 1.4	17.0 ± 0.5	<0.0001
Postprocedure complications	HVBH	LVBH	value unadjusted	ATE (95% CI)	value adjusted
Bowel obstruction (%± SE)	3.4 ± 1.3	4.8 ± 0.7	0.38	−1.53 (−4.60/1.55)	0.33
Pulmonary insufficiency (%± SE)	0.49 ± 0.49	0.11 ± 0.11	0.26	—	—
Pulmonary failure (%± SE)	0.49 ± 0.49	3.22 ± 0.59	0.03	−2.28 (−4.20/−0.35)	0.02
Pneumonia (%± SE)	0.49 ± 0.48	0.57 ± 0.26	0.88	—	—
Postoperative infection (%± SE)	0.98 ± 0.67	0.69 ± 0.28	0.66	—	—
Venous thromboembolism (%± SE)	0.49 ± 0.49	0.23 ± 0.16	0.53	—	—
Pulmonary embolism (%± SE)	0.49 ± 0.49	0.46 ± 0.23	0.96	—	—
Death (%± SE)	0.98 ± 0.63	0.23 ± 0.16	0.10	—	—
Patient had any complication (%± SE)	6.8 ± 2.0	9.4 ± 1.0	0.28	−3.29 (−7.23/0.64)	0.10

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