Characterizing the performance and outcomes of obesity surgery in California.

摘要: Between 1991 and 2000, the prevalence of obesity increased 65 per cent. As a result, increasing research is being directed at gastric bypass (GB) surgery, an operation that appears to achieve long-term weight reduction. Despite rapid proliferation this quality care population level largely unknown. This study examines longitudinal trends in identifies significant predictors adverse outcomes. Using California inpatient discharge database, all GB operations from 1996 2000 were identified. Demographic, comorbidity, complication, volume data obtained. Complications defined as life-threatening cardiac, respiratory, or medical (renal failure shock) events. Comorbidity was graded on modified Charlson score. Annual hospital categorized into four groups: <50, 50-99, 100-199, 200+ cases. Based these data, we calculated complication rate performed logistic regression identify complications. A total 16,232 patients included. The average age 41 years; 84 cent female, 83.5 white. 10.4 rates cardiac respiratory complications decreased while remained unchanged. more likely men [odd ratio (OR) = 1.69 compared women] with comorbidities (OR 1.60 for each additional comorbid disease). Furthermore, when examining effect volume, very low (<50) (50-99) hospitals much have 2.72 2.70, respectively) high-volume (200+), even after controlling differences case-mix. surgery has improved between 2000. operating decreased. three independent complications: gender, volume. These findings are important initial steps toward improving surgery.