Bariatric surgery safer when performed at accredited centers

Bariatric surgery is significantly safer when performed at an accredited center, according to new research presented here at the 30th Annual Meeting for the American Society for Metabolic and Bariatric Surgery (ASMBS) during ObesityWeek 2013, the largest international event focused on the basic science, clinical application and prevention and treatment of obesity. The event is hosted by the ASMBS and The Obesity Society (TOS).

Using a nationwide database, researchers from the University of California (UC) Irvine School of Medicine analyzed data from 277,068 weight loss operations performed between 2008 and 2011 and found patients who had bariatric surgery at an accredited center had an in-hospital mortality of 0.08 percent, while those who had surgery at a non-accredited center had a mortality rate of 0.19 percent, a rate nearly three times higher.

“This study further reinforces that accreditation saves lives,” said Ninh T. Nguyen, MD, FACS, study co-author, Vice-Chair of the Department of Surgery at UC Irvine School of Medicine and the next president of the ASMBS. “This is not a small difference in outcomes.”

Requirements for accreditation include surgeons perform a minimum of 50 bariatric stapling procedures annually, staff members training in metabolic and bariatric surgery and the availability of equipment that can accommodate patients with severe obesity. 

This study comes less than two months after the Centers for Medicare & Medicaid Services (CMS) dropped its 7-year-old accreditation requirement for bariatric surgery facilities performing surgery on Medicare beneficiaries, considered among the highest risk patients because of age and disease severity. 

The UC Irvine study found significantly lower mortality rates for high-risk patients at accredited centers. The mortality rate for the sickest patients was 0.17 percent at accredited centers and 0.45 percent at non-accredited centers. Additionally, patients at accredited centers did better after other laparoscopic operations including antireflux and gallbladder surgery, where in both cases complication rates were lower.

“The bottom line is if you have severe obesity and are considering bariatric surgery or even other laparoscopic procedures, you should seek out an accredited center,” added Dr. Nguyen.

Several previous studies have shown accreditation improves outcomes, including a recent study published earlier this year in the journal, Surgical Endoscopy. It found non-accredited bariatric centers had an in-hospital mortality rate also about three times higher than accredited centers (0.22% vs. 0.06%, respectively) with similar volume.