Obesity :: Bariatric surgery patients have fewer complications at high-volume hospitals

Bariatric surgery patients had 64 percent fewer complications and a 26 percent shorter hospital stay if they went to a five-star rated hospital compared with a one-star rated hospital, according to a new study released today by HealthGrades, the healthcare ratings company.

The study of bariatric surgery outcomes at hospitals in 19 states over the years 2003 to 2005 also found that five-star rated hospitals ? those with better-than-average patient outcomes — performed about twice the number of procedures compared with hospitals that rated poorly.

A clear trend away from traditional, more invasive gastric bypass to a less invasive laparoscopic procedure was also found in the study, according to the second annual HealthGrades Bariatric Surgery Trends in American Hospitals. Over 70 percent of the surgeries done in 2005 were laparoscopic, which are associated with fewer inhospital complications than traditional gastric bypass.

?Bariatric surgery has been demonstrated to be highly effective for those with morbid obesity, but the relatively new procedures are not yet regulated or a credentialed surgical subspecialty,? said Samantha Collier, MD., HealthGrades? chief medical officer. ?So it is important that patients considering surgery know how hospitals rate.?

The HealthGrades study analyzed 166,410 bariatric surgery procedures in the years 2003, 2004 and 2005 in the 19 states that collect and release all-payer outcomes data. Those states are: Arizona, California, Florida, Iowa, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Virginia, Washington and Wisconsin.

HealthGrades? quality ratings for bariatric surgery at individual hospitals in these 19 states were posted today to www.HealthGrades.com as a free resource for consumers. Each hospital receives a star rating based on their patient outcomes for bariatric surgery. Hospitals with above-average outcomes receive a five-star rating. Hospitals with average outcomes receive a three-star rating, and hospitals with outcomes that are below average receive a one-star rating.

The second annual HealthGrades Bariatric Surgery Trends in American Hospitals Study found that:

  • Hospitals rated with five stars by HealthGrades performed, on average, almost twice the number of procedures during the three years studied compared with those rated with one star ? 533 procedures compared with 293 for one-star hospitals.
  • Patients at one-star rated hospitals had, on average, a 16.07% chance of experiencing an in-hospital complication; patients at a five-star rated hospital had, on average, a 5.60% percent chance.
  • A typical patient at a five-star rated hospital had, a 64 percent lower chance of developing one or more major inhospital complications compare to a one-star hospital, and a 41 percent lower chance compared to all hospitals studied.
  • The most common major complications include respiratory, bleeding, gastrointestinal and laceration complications.
  • The average length of stay was 26 percent shorter in five-star hospitals as compared to one-star rated hospitals.
  • Among the 19 states studies, almost half of all the procedures were performed in just four states ? New York, Pennsylvania, Texas and Florida

Last year, a study published by the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality found that four of every ten patients undergoing bariatric surgery develop complications within six months.


For this study, HealthGrades analyzed 166,410 bariatric procedures performed in the years 2003, 2004 and 2005. To make accurate and valid comparisons of clinical outcomes at different hospitals with different patient characteristics, HealthGrades risk adjusted the data using multivariate logistic regression-based ratings to account for age, gender and underlying medical conditions that could increase the patient?s risk of mortality or complication.

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