Ivy N Haskins, MD, Sheena W Chen, MD, Ada Graham, MD, Andrew D Sparks, MS, Paul P Lin, MD, FACS, Hope T Jackson, MD, Khashayar Vaziri, MD. George Washington University
Introduction: Surgeon and hospital volume are two factors that have been shown to impact outcomes following bariatric surgery. However, there is a paucity of literature investigating surgeon training on bariatric surgery outcomes. The purpose of this study was to determine if bariatric specialty training leads to improved short-term outcomes following laparoscopic bariatric surgery.
Methods: All patients undergoing first-time, elective, laparoscopic bariatric surgery from 2015-2016 were identified within the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. These patients were divided into two groups based on surgeon training, including general surgery training only or metabolic and bariatric surgery training. Thirty-day outcomes following laparoscopic bariatric surgery were compared between the two groups using multivariate logistical regression analysis.
Results: A total of 140,340 patients met inclusion criteria; 4,598 (3.3%) patients underwent bariatric surgery by a general surgeon. These patients were lower risk as evidenced by their overall functional status and American Society of Anesthesia (ASA) classification. Despite being lower risk, patients who underwent surgery by a general surgeon were significantly more likely to be discharged to a facility (OR: 3.6, CI: 2.56-5.13, p<0.0001) while patients who underwent surgery by a metabolic and bariatric surgeon were significantly less likely to be readmitted to the hospital within 30-days of their index bariatric surgery (OR: 0.81, CI: 0.67-0.97, p=0.02).
Conclusion: Patients who undergo bariatric surgery by a general surgeon are more likely to be discharged to a facility and to be readmitted within 30-days of surgery. These differences in 30-day outcomes could be related to differences in postoperative support provided by the surgeon types and the institutions where they perform bariatric surgery. Additional information is needed with regards to the type of postoperative support provided following bariatric surgery and to determine if general surgeons are more or less likely to perform bariatric procedures at designated centers of excellence.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94571
Program Number: P181
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster