Dr Parker and colleagues from the USA examined hospital volume in New York state as a predictor of complications after bariatric surgery over 13 years.
The team analyzed data from the New York state Statewide Planning and Research Cooperative Systems database by diagnosis-related group, patient demographics, and outcomes.
|Case volume increased 36-fold in high-volume centers|
The institution data were analyzed on the basis of volume and logistic regression using chi-square analysis for predicting morbidity and mortality.
The research team found that from 1991 to 2003, 24,534 patients underwent bariatric surgery at 79 institutions.
Case volume increased 36-fold in high-volume centers, whereas the overall number of institutions doubled.
The team noted that the average mortality rate was 1% in low-volume centers, 0.4% in medium-volume centers, and 0.2% in high-volume centers.
About 12% of the low-volume center patients had postoperative anastomotic complications.
The research team observed that only 10% had postoperative anastomotic complications in medium-volume centers.
The team found that only 7% had postoperative anastomotic complications in high-volume centers.
In addition, the researchers noted that less than 1% of the patients required postoperative reintubation after surgery at high-volume centers.
Only 2% of patients required postoperative reintubation at medium-volume centers, and 2% at low-volume centers.
The team identified 2% of patients requiring blood transfusion of packed red blood cells at high-volume centers, medium-volume centers and low-volume centers .
Dr Parker's team concluded, "Experience correlates with fewer postoperative complications, including death, in bariatric centers in New York state."