title: Bariatric surgery results: reporting clinical characteristics and adverse outcomes from an integrated healthcare delivery system.
abstract: BACKGROUND
  Limited data have been reported on bariatric surgery within a large, high-volume regional multicenter integrated healthcare delivery system.
  
  
  OBJECTIVE
  Review clinical characteristics and short- and intermediate-term outcomes and adverse events from a bariatric surgery program within an integrated healthcare delivery system.
  
  
  METHODS
  Single high-volume, multicenter regional integrated healthcare delivery system.
  
  
  METHODS
  Adult patients who underwent primary bariatric surgery during 2010-2011 were reviewed. Clinical characteristics, outcomes, and weight loss results were extracted from the electronic medical record.
  
  
  RESULTS
  A total of 2399 patients were identified within the study period. The 30-day rates of clinical outcomes for Roux-en-Y gastric bypass (RYGB; n = 1313) and sleeve gastrectomy (SG; n = 1018) were 2.9% for readmission, 3.0% for major complications, .8% for reoperation, and 0% for mortality. One-year and 2-year weight loss results were as follows: percent weight loss (%WL) was 31.4 (±SD 8.5) and 34.2±12.0% for SG and 34.1±9.3 and 39.1±11.9 for RYGB; percent excess weight loss (%EBWL) was 64.2±18.0 and 69.8±23.7 for SG and 68.0±19.3 and 77.8±23.7 for RYGB; percent excess body mass index loss (%EBMIL) was 72.9±21.0 and 77.7±22.4 for SG and 76.6±22.1% and 85.6±21.6 for RYGB. Follow-up for each procedure at 1 year was 76% for SG (n = 778) and 80% for RYGB (n = 1052) and at 2 years was 65% for SG (n = 659) and 67% for RYGB (n = 875).
  
  
  CONCLUSIONS
  A large regional high-volume multicenter bariatric program within an integrated healthcare delivery system can produce excellent short-term results with low rates of short- and intermediate-term adverse outcomes.
authors.affiliation: Kaiser Permanente Hospital, South San Francisco, California. Electronic address: robert.a.li@kp.org.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Li
authors.affiliation: Kaiser Permanente Hospital, Richmond, California.
authors.forename: David P
authors.initials: DP
authors.lastname: Fisher
authors.affiliation: Kaiser Permanente Hospital, Fremont, California.
authors.forename: Sanjoy
authors.initials: S
authors.lastname: Dutta
authors.affiliation: Kaiser Permanente Hospital, Fremont, California.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: O'Brien
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Ackerson
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Sorel
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, California.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sidney
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods*; D015992:Body Mass Index; D002140:California; D015331:Cohort Studies; D016208:Databases, Factual; D019033:Delivery of Health Care, Integrated / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D061847:Hospitals, High-Volume; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors
keywords: Bariatric surgery; Integrated healthcare delivery system; Obesity; Outcomes