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A state-wide review of contemporary outcomes of gastric bypass in Florida: does provider volume impact outcomes?

Publication ,  Journal Article
Murr, MM; Martin, T; Haines, K; Torrella, T; Dragotti, R; Kandil, A; Gallagher, SF; Harmsen, S
Published in: Ann Surg
May 2007

OBJECTIVES: To report contemporary outcomes of gastric bypass for obesity and to assess the relationship between provider volume and outcomes. BACKGROUND: Certain Florida-based insurers are denying patients access to bariatric surgery because of alleged high morbidity and mortality. SETTINGS AND PATIENTS: The prospectively collected and mandatory-reported Florida-wide hospital discharge database was analyzed. Restrictive procedures such as adjustable gastric banding and gastroplasty were excluded. RESULTS: The overall complication and in-hospital mortality rates in 19,174 patients who underwent gastric bypass from 1999 to 2003 were 9.3% (8.9-9.7) and 0.28% (0.21-0.36), respectively. Age and male gender were associated with increased duration of hospital stay (P < 0.001), increased in-hospital complications [age: odds ratio (OR) = 1.11, CI: 1.08-1.13; male: OR = 1.53, CI: 0.36-1.72] and increased in-hospital mortality (age: OR = 1.51, CI: 1.32-1.73; male: CI = 2.66, CI: 1.53-4.63), all P < 0.001. The odds of in-hospital complications significantly increased with diminishing surgeon or hospital procedure volume (surgeon: OR = 2.0, CI: 1.3-3.1; P < 0.001, 1-5 procedures relative to >500 procedures; hospital volume: OR = 2.1, CI: 1.2-3.5; P < 0.001, 1-9 procedures relative to >500 procedures). The percent change of in-hospital mortality in later years of the study was lowest, indicating higher mortality rates, for surgeons or hospitals with fewer (< or =100) compared with higher (> or =500) procedures. CONCLUSION: Increased utilization of bariatric surgery in Florida is associated with overall favorable short-term outcomes. Older age and male gender were associated with increased morbidity and mortality. Surgeon and hospital procedure volume have an inverse relationship with in-hospital complications and mortality.

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Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

May 2007

Volume

245

Issue

5

Start / End Page

699 / 706

Location

United States

Related Subject Headings

  • Workload
  • Surgery
  • Sex Factors
  • Outcome Assessment, Health Care
  • Obesity
  • Middle Aged
  • Male
  • Logistic Models
  • Length of Stay
  • Humans
 

Citation

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Chicago
ICMJE
MLA
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Murr, M. M., Martin, T., Haines, K., Torrella, T., Dragotti, R., Kandil, A., … Harmsen, S. (2007). A state-wide review of contemporary outcomes of gastric bypass in Florida: does provider volume impact outcomes? Ann Surg, 245(5), 699–706. https://doi.org/10.1097/01.sla.0000256392.04141.04
Murr, Michel M., Taylor Martin, Krista Haines, Tracy Torrella, Robert Dragotti, Ali Kandil, Scott F. Gallagher, and Scott Harmsen. “A state-wide review of contemporary outcomes of gastric bypass in Florida: does provider volume impact outcomes?Ann Surg 245, no. 5 (May 2007): 699–706. https://doi.org/10.1097/01.sla.0000256392.04141.04.
Murr MM, Martin T, Haines K, Torrella T, Dragotti R, Kandil A, et al. A state-wide review of contemporary outcomes of gastric bypass in Florida: does provider volume impact outcomes? Ann Surg. 2007 May;245(5):699–706.
Murr, Michel M., et al. “A state-wide review of contemporary outcomes of gastric bypass in Florida: does provider volume impact outcomes?Ann Surg, vol. 245, no. 5, May 2007, pp. 699–706. Pubmed, doi:10.1097/01.sla.0000256392.04141.04.
Murr MM, Martin T, Haines K, Torrella T, Dragotti R, Kandil A, Gallagher SF, Harmsen S. A state-wide review of contemporary outcomes of gastric bypass in Florida: does provider volume impact outcomes? Ann Surg. 2007 May;245(5):699–706.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

May 2007

Volume

245

Issue

5

Start / End Page

699 / 706

Location

United States

Related Subject Headings

  • Workload
  • Surgery
  • Sex Factors
  • Outcome Assessment, Health Care
  • Obesity
  • Middle Aged
  • Male
  • Logistic Models
  • Length of Stay
  • Humans