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Attending Specialization and 30-Day Outcomes Following Laparoscopic Bariatric Surgery: an Analysis of the ACS-MBSAQIP Database

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Abstract

Background

Surgeon and hospital volume are factors that have been shown to impact outcomes following bariatric surgery. Nevertheless, there is a paucity of literature investigating surgeon training on bariatric surgery outcomes. The purpose of our study was to determine if bariatric specialty training leads to improved short-term outcomes following laparoscopic bariatric surgery using the American College of Surgeons Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (ACS-MBSAQIP) database.

Methods

All patients undergoing first-time, elective, laparoscopic bariatric surgery from 2015 to 2016 were identified within the ACS-MBSAQIP database. Patients were divided into two groups based on the type of bariatric procedure performed and the surgeon performing the procedure. Thirty-day outcomes were compared between the groups using multivariable logistic regression analysis.

Results

A total of 140,340 patients met inclusion criteria. Higher risk patients with more associated comorbidities underwent bariatric surgery by a metabolic and bariatric surgeon. After controlling for these differences, patients who underwent Roux-en-Y gastric bypass (RYGB) had similar 30-day irrespective of the surgeon performing the procedure while patients who underwent sleeve gastrectomy (SG) by a metabolic and bariatric surgeon (MBS) had improved 30-day outcomes.

Conclusion

Surgeon type is associated with 30-day morbidity and mortality outcomes for SG but not for RYGB. These differences in 30-day morbidity and mortality outcomes may be facilitated by institutional factors, surgeon experience, and participation in bariatric surgery accredited centers. Standardization of the perioperative process for both surgeons and institutions may improve 30-day morbidity and mortality outcomes for all patients who undergo laparoscopic bariatric surgery.

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Authors and Affiliations

  1. Department of Surgery, George Washington University, 2150 Pennsylvania Avenue, NW, Suite 6B, Washington, DC, 20037, USA

    Ivy N. Haskins, Sheena Chen, Ada E. Graham, Andrew D. Sparks, Paul P. Lin, Khashayar Vaziri & Hope T. Jackson

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  1. Ivy N. Haskins
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  2. Sheena Chen
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  3. Ada E. Graham
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  4. Andrew D. Sparks
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  6. Khashayar Vaziri
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  7. Hope T. Jackson
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Correspondence to Hope T. Jackson.

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The authors declare that they have no conflict of interest.

MBSAQIP Disclaimer Statement

The American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (ACS-MBSAQIP) and the hospitals participating in the ACS-MBSAQIP are the source of the date used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

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Haskins, I.N., Chen, S., Graham, A.E. et al. Attending Specialization and 30-Day Outcomes Following Laparoscopic Bariatric Surgery: an Analysis of the ACS-MBSAQIP Database. OBES SURG 30, 1827–1836 (2020). https://doi.org/10.1007/s11695-020-04402-w

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  • DOI: https://doi.org/10.1007/s11695-020-04402-w

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