Abstract
Background
Bariatric surgery is the most effective method of sustainable weight loss for the treatment of morbid obesity. Low mortality associated with these procedures has been reported internationally; however, Australian outcomes are yet to be published. Despite its efficacy, limited access to bariatric surgery exists in Australian public hospitals. This retrospective data analysis was conducted for two reasons. Firstly, to determine the perioperative mortality rate (POMR) associated with bariatric procedures in Australia, and secondly, to compare public and private hospital bariatric surgery admission demographics and outcomes.
Method
A retrospective review of de-identified patient data from the National Hospital Morbidity Database, held by the Australian Institute of Health and Welfare (AIHW), was conducted using codes relating to bariatric procedures. POMR calculations were established using AIHW admission data from 1 July 2005 to 30 June 2013.
Results
From 1 July 2005 to 30 June 2013, 113,929 patient admissions occurred for patients undergoing a bariatric procedure. Thirty-nine deaths occurred nationally, with an overall average POMR of 0.03%. A higher POMR was associated with public admissions and secondary procedures. A higher proportion of secondary procedures were performed in public hospitals. Primary bariatric procedure incidence increased throughout the study period while secondary bariatric procedure incidence decreased.
Conclusion
This study demonstrates the Australian bariatric procedure POMR to be substantially lower than internationally reported figures. Public hospitals were shown to perform far fewer bariatric procedures at a higher POMR than private hospitals. Public hospitals performed a higher proportion of secondary revision procedures.
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References
Buchwald H, Buchwald JN, TW MG. Systematic review and meta-analysis of medium-term outcomes after banded Roux-en-Y gastric bypass. Obes Surg. 2014;24:1536–51.
Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults Cochrane Database Syst Rev. 2014 Aug 08(8):CD003641.
Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012. JAMA Surg. 2014;149:275–87.
Bariatric Surgery Registry. Fourth report of the Bariatric Surgery Registry 2016 (Updated June 2016) Available at http://www.med.monash.edu.au/sphpm/depts-centres-units/bariatric/docs/bsr-4th-report-june-2016.pdf. Accessed 10/08/2016
Korda RJ, Joshy G, Jorm LR, et al. Inequalities in bariatric surgery in Australia: findings from 49,364 obese participants in a prospective cohort study. Med J Aust. 2012;197:631–6.
Stringer KM, Bryant R, Hopkins GH, et al. Gastric banding at the royal brisbane and women’s hospital: trials and tribulations of a public service. ANZ J Surg. 2007;77:550–2.
Sharman MJ, Hensher M, Wilkinson S, et al. Review of publicly-funded bariatric surgery policy in Australia—lessons for more comprehensive policy making. Obes Surg. 2016;26:817–24.
Meyer SB, Thompson C, Hakendorf P, et al. Bariatric surgery revisions and private health insurance. Obes Res Clin Pract 2017: 11; 616-621
Watters DA, Hollands MJ, Gruen RL, et al. Perioperative mortality rate (POMR): a global indicator of access to safe surgery and anaesthesia. World J Surg. 2015;39:856–64.
Khan MA, Grinberg R, Johnson S, et al. Perioperative risk factors for 30-day mortality after bariatric surgery: is functional status important? Surg Endosc. 2013;27:1772–7.
The United Kingdon National Bariatric Surgery Registry. Bariatric Surgeon Level Outcomes Data Report 2013 (Updated 2 July 2013) Available at: http://www.bomss.org.uk/wp-contents/uploads/2014/04/Bariatric-Surgeon-Level-Outcomes-Data-Report-2-July-2013.pdf. Accessed 10/08/2016
Smith FJ, Holman CD, Moorin RE, et al. Incidence of bariatric surgery and postoperative outcomes: a population-based analysis in Western Australia. Med J Aust. 2008;189:198–202.
Harris I, Madan A, Naylor J, et al. Mortality rates after surgery in New South Wales. ANZ J Surg. 2012;82:871–7.
Johnson EE, Simpson AN, Harvey JB, et al. Bariatric surgery implementation trends in the USA from 2002 to 2012. Implement Sci. 2016;11:21.
Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23:427–36.
Samuel I, Mason EE, Renquist KE, et al. Bariatric surgery trends: an 18-year report from the International Bariatric Surgery Registry. Am J Surg. 2006;192:657–62.
Buchwald H, Estok R, Fahrbach K, et al. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery. 2007;142:621–32. discussion 632-625
Morino M, Toppino M, Forestieri P, et al. Mortality after bariatric surgery: analysis of 13,871 morbidly obese patients from a national registry. Ann Surg. 2007;246:1002–7. discussion 1007-1009
Sjostrom L, Gummesson A, Sjostrom CD, et al. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol. 2009;10:653–62.
Kiermeier A, Babidge WJ, McCulloch GAJ, et al. National surgical mortality audit may be associated with reduced mortality after emergency admission ANZ J Surg 2017: 87; 830-836
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Davis, S., Babidge, W., Kiermeier, A. et al. Perioperative Mortality Following Bariatric Surgery in Australia. OBES SURG 28, 1329–1334 (2018). https://doi.org/10.1007/s11695-017-3010-1
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DOI: https://doi.org/10.1007/s11695-017-3010-1