Bariatric surgery results: reporting clinical characteristics and adverse outcomes from an integrated healthcare delivery system

被引:12
作者
Li, Robert A. [1 ]
Fisher, David P. [2 ]
Dutta, Sanjoy [3 ]
O'Brien, Rebecca M. [3 ]
Ackerson, Lynn M. [4 ]
Sorel, Michael E. [4 ]
Sidney, Stephen [4 ]
机构
[1] Kaiser Permanente Hosp, San Francisco, CA 94080 USA
[2] Kaiser Permanente Hosp, Richmond, CA USA
[3] Kaiser Permanente Hosp, Fremont, CA USA
[4] Kaiser Permanente No Calif, Div Res, Oakland, CA USA
关键词
Bariatric surgery; Obesity; Integrated healthcare delivery system; Outcomes; LAPAROSCOPIC-SLEEVE-GASTRECTOMY; GASTRIC BYPASS; METAANALYSIS; MORTALITY; CENTERS; COMPLICATIONS; EXCELLENCE; MICHIGAN; SAFETY; RISK;
D O I
10.1016/j.soard.2015.03.002
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Limited data have been reported on bariatric surgery within a large, high-volume regional multicenter integrated healthcare delivery system. Objectives: Review clinical characteristics and short- and intermediate-term outcomes and adverse events from a bariatric surgery program within an integrated healthcare delivery system. Setting: Single high-volume, multicenter regional integrated healthcare delivery system. Methods: Adult patients who underwent primary bariatric surgery during 2010-2011 were reviewed. Clinical characteristics, outcomes, and weight loss results were extracted from the electronic medical record. Results: A total of 2399 patients were identified within the study period. The 30-day rates of clinical outcomes for Roux-en-Y gastric bypass (RYGB; n = 1313) and sleeve gastrectomy (SG; n = 1018) were 2.9% for readmission, 3.0% for major complications, .8% for reoperation, and 0% for mortality. One-year and 2-year weight loss results were as follows: percent weight loss (%WL) was 31.4 (+/- SD 8.5) and 34.2 +/- 12.0% for SG and 34.1 +/- 9.3 and 39.1 +/- 11.9 for RYGB; percent excess weight loss (%EBWL) was 64.2 +/- 18.0 and 69.8 +/- 23.7 for SG and 68.0 +/- 19.3 and 77.8 +/- 23.7 for RYGB; percent excess body mass index loss (%EBMIL) was 72.9 +/- 21.0 and 77.7 +/- 22.4 for SG and 76.6 +/- 22.1% and 85.6 +/- 21.6 for RYGB. Follow-up for each procedure at 1 year was 76% for SG (n = 778) and 80% for RYGB (n = 1052) and at 2 years was 65% for SG (n = 659) and 67% for RYGB (n = 875). Conclusions: A large regional high-volume multicenter bariatric program within an integrated healthcare delivery system can produce excellent short-term results with low rates of short- and intermediate-term adverse outcomes. (C) 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.
引用
收藏
页码:1119 / 1125
页数:7
相关论文
共 24 条
[1]   Long-term mortality after gastric bypass surgery [J].
Adams, Ted D. ;
Gress, Richard E. ;
Smith, Sherman C. ;
Halverson, R. Chad ;
Simper, Steven C. ;
Rosamond, Wayne D. ;
LaMonte, Michael J. ;
Stroup, Antoinette M. ;
Hunt, Steven C. .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 357 (08) :753-761
[2]   Hospital Complication Rates With Bariatric Surgery in Michigan [J].
Birkmeyer, Nancy J. O. ;
Dimick, Justin B. ;
Share, David ;
Hawasli, Abdelkader ;
English, Wayne J. ;
Genaw, Jeffrey ;
Finks, Jonathan F. ;
Carlin, Arthur M. ;
Birkmeyer, John D. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2010, 304 (04) :435-442
[3]   Bariatric surgery: A systematic review and meta-analysis [J].
Buchwald, H ;
Avidor, Y ;
Braunwald, E ;
Jensen, MD ;
Pories, W ;
Fahrbach, K ;
Schoelles, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (14) :1724-1737
[4]   Trends in mortality in bariatric surgery: A systematic review and meta-analysis [J].
Buchwald, Henry ;
Estok, Rhonda ;
Fahrbach, Kyle ;
Banel, Deirdre ;
Sledge, Isabella .
SURGERY, 2007, 142 (04) :621-632
[5]   The Effectiveness and Risks of Bariatric Surgery An Updated Systematic Review and Meta-analysis, 2003-2012 [J].
Chang, Su-Hsin ;
Stoll, Carolyn R. T. ;
Song, Jihyun ;
Varela, J. Esteban ;
Eagon, Christopher J. ;
Colditz, Graham A. .
JAMA SURGERY, 2014, 149 (03) :275-287
[6]   Laparoscopic Roux-en-Y Gastric Bypass or Laparoscopic Sleeve Gastrectomy as Revisional Procedure after Adjustable Gastric Band-a Systematic Review [J].
Coblijn, Usha K. ;
Verveld, Caroline J. ;
van Wagensveld, Bart A. ;
Lagarde, Sjoerd M. .
OBESITY SURGERY, 2013, 23 (11) :1899-1914
[7]   Three-year weight outcomes from a bariatric surgery registry in a large integrated healthcare system [J].
Coleman, Karen J. ;
Huang, Yii-Chieh ;
Hendee, Fadi ;
Watson, Heather L. ;
Casillas, Robert A. ;
Brookey, John .
SURGERY FOR OBESITY AND RELATED DISEASES, 2014, 10 (03) :396-403
[8]   Baseline data from American Society for Metabolic and Bariatric Surgery-designated Bariatric Surgery Centers of Excellence using the Bariatric Outcomes Longitudinal Database [J].
DeMaria, Eric J. ;
Pate, Virginia ;
Warthen, Michael ;
Winegar, Deborah A. .
SURGERY FOR OBESITY AND RELATED DISEASES, 2010, 6 (04) :347-355
[9]   Bariatric Surgery Complications Before vs After Implementation of a National Policy Restricting Coverage to Centers of Excellence [J].
Dimick, Justin B. ;
Nicholas, Lauren H. ;
Ryan, Andrew M. ;
Thumma, Jyothi R. ;
Birkmeyer, John D. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2013, 309 (08) :792-799
[10]   Predicting Risk for Serious Complications With Bariatric Surgery Results from the Michigan Bariatric Surgery Collaborative [J].
Finks, Jonathan F. ;
Kole, Kerry L. ;
Yenumula, Panduranga R. ;
English, Wayne J. ;
Krause, Kevin R. ;
Carlin, Arthur M. ;
Genaw, Jeffrey A. ;
Banerjee, Mousumi ;
Birkmeyer, John D. ;
Birkmeyer, Nancy J. .
ANNALS OF SURGERY, 2011, 254 (04) :633-640