Abstract
Aim
To examine the association between the certification as bariatric surgery center and volume and patient outcome, data collected in the German Bariatric Surgery Registry were evaluated. All data were registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at Otto-von-Guericke University Magdeburg.
Methods
Data collection began in 2005 for all bariatric procedures in an online database. Participation in the quality assurance study is required for all certified bariatric surgery centers in Germany. Descriptive evaluation and matched pairs analysis were performed. Patients were matched via propensity score taking into account BMI, age, and incidence of comorbidities.
Results
During the period from 2005 to 2013, 3083 male and 10,639 female patients were operated on with the RYGB primary approach. In Centers of Competence (77.2 %) and non-accredited hospitals (76.3 %), the proportion of female patients was significantly lower than in Centers of Reference/Excellence (78.7 %; p = 0.002). The mean age in Centers of Reference/Excellence (41.2 years) was significantly lower than in Centers of Competence (43.2 years; p < 0.05). Propensity score analysis was performed to compare matched patients with regard to BMI, age, and incidence of comorbidities. The rate of general and surgical postoperative complications and mortality rate was significantly lower in certified Centers of Reference/Excellence compared to Centers of Competence with 29 and non-certified hospitals.
Conclusion
There is evidence of improved patient outcome in certified bariatric surgery centers with higher volume. The study supports the concept of certification. There are different factors which can and cannot be preoperatively modified and influence the perioperative outcome.
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Acknowledgments
The following companies support the GBSR without any relation to their products:
Johnson & Johnson MEDICAL GmbH, Ethicon Endo-Surgery Germany, Norderstedt and Covidien Germany GmbH, Neustadt/Donau.
We thank all hospitals that participated in the study for their active engagement.
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The present study is a prospective cohort study on quality assurance and, in the form of the GBSR, has been sponsored since 2012 by the German Federal Ministry of Education and Research (BMBF). Data were collected online using an internet database “Postgres” in compliance with the German data protection guidelines and the Declaration of Helsinki for biomedical research. Additional informed consent was obtained from all individual patients included in the study.
Conflict of Interest
The German Nationwide Survey on Bariatric Surgery is supported by the Ministry of Research and Education Germany (BMBF) grant number 01GI1124. The responsible investigator is Christine Stroh.
All authors confirm that there are no links to companies whose products are mentioned in the article or to companies marketing a competing product. The topic is presented in an independent light, and the information outlined is product neutral.
All authors confirm that no conflicts of interests exist.
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Stroh, C., Köckerling, F., Lange, V. et al. Does Certification as Bariatric Surgery Center and Volume Influence the Outcome in RYGB—Data Analysis of German Bariatric Surgery Registry. OBES SURG 27, 445–453 (2017). https://doi.org/10.1007/s11695-016-2340-8
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DOI: https://doi.org/10.1007/s11695-016-2340-8