Thirty-day death rates from bariatric surgery in California, rose from 1.3 per 1,000 patients to 1.5 between 2005 and 2008, according to a report released Wednesday.
One-year death rates were 3.3 per 1,000 or about 33 deaths. About 12.4% of patients experienced a complication, such as hemorrhage, or had to undergo a repeat surgery, an improvement from 13.1% in 2005.
California is the only state besides New Jersey that publicly tracks the procedure by hospital.
The report found that while some hospitals do a lot of bariatric procedures, many hospitals are doing relatively few. Of the 94 hospitals performing bariatric procedures, 55 hospitals performed fewer than the 125 in 2009, which is the minimum volume required for ASMBS accreditation, according to the American Society for Metabolic and Bariatric Surgery's president Robin Blackstone, MD. Of the 94 hospitals, 38 performed fewer than 60 and 16 did 10 or less.
"With this report, we provide the state average risk of death, complications, and hospital readmission rates for each type of bariatric procedure and how that's changed," said Joe Parker, director of the Healthcare Outcomes Center at the California Office of Statewide Health Planning and Development, which produced the report. "And we also let everyone know what hospitals are doing what kinds of procedures and how many."
Parker acknowledges that although there is some information in the medical literature linking the number of procedures a hospital or surgeon does with better outcomes, it is inconclusive. Nevertheless, he said, "we provide this information to physicians and consumers and let them discuss how important that may be in their decision-making."