Evidence map›Paper›PMID 34471980›Full record

ArticleSurgical endoscopy2022

Volume-outcome relationships for Roux-en-Y gastric bypass patients in the sleeve gastrectomy era.

Grace F Chao, Jie Yang, Jyothi Thumma, Karan R Chhabra, David E Arterburn, Andrew Ryan, Dana A Telem, Justin B Dimick

Erratum issuedAbstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Volume‒outcome relationships in bariatric surgery: a rapid review.International journal of obesity (2005) · 2026
    Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Grace F ChaoNational Clinician Scholars Program at the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA. grace.f.chao@yale.edu.ORCID http://orcid.org/0000-0003-3133-9827
Jie YangCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Jyothi ThummaCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Karan R ChhabraNational Clinician Scholars Program at the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
David E ArterburnKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Andrew RyanCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Dana A TelemCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Justin B DimickCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
University of Michigan · USKaiser Permanente Washington Health Research Institute · USBrigham and Women's Hospital · US

Funding

Developing and Implementing Evidence-Based Hernia CareK08HS025778 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI TELEM, DANA ALEXA · 2018 to 2021
$561k
AHRQ HHS K08 HS025778
6 · The paper itself

Abstract

backgroundSleeve gastrectomy is now the most common bariatric operation performed. With lower volumes of Roux-en-Y gastric bypass (RYGB), it is unclear whether decreasing surgeon experience has led to worsening outcomes for this procedure.

methodsWe used State Inpatient Databases from Florida, Iowa, New York, and Washington. Bariatric surgeons were designated as those who performed ten or more bariatric procedures yearly. Patients who had RYGB were included in our analysis. Using multi-level logistic regression, we examined whether surgeon average yearly RYGB volume was associated with RYGB patient 30-day complications, reoperations, and readmissions and 1-year revisions and readmissions.

resultsFrom 2013 to 2017 there were 27,714 patients who underwent laparoscopic RYGB by 311 surgeons. Median surgeon volume was 77 RYGBs per year. The distribution was 10 bypasses yearly at the 5th percentile, 16 bypasses at the 10th percentile, 38 bypasses at the 25th percentile, and 133 bypasses at the 75th percentile. Multi-level regression revealed that patients of surgeons with lower RYGB volumes had small but statistically significant increased risks of 30-day complications and 1-year readmissions. At 30 days, risk for any complication was 6.71%, 6.43%, and 5.55% at 10, 38, and 133 bypasses per year, respectively (p = 0.01). Risk for readmission at 1 year was 13.90%, 13.67%, and 12.90% at 10, 38, and 133 bypasses per year, respectively (p = 0.099). Of note, volume associations with complications and reoperations due to hemorrhage and leak were not statistically significant. There was also no significant association with revisions.

conclusionThis is the first study to examine the association of surgeon RYGB volume with patient outcomes as the national experience with RYGB diminishes. Overall, surgeon RYGB volume does not appear to have a large effect on patient outcomes. Thus, patients can safely pursue RYGB in this early phase of the sleeve gastrectomy era.

Indexed as

Bariatric SurgeryGastric BypassObesity, MorbidGastrectomyHumansRetrospective StudiesTreatment OutcomeBariatric surgery outcomesRoux-en-Y gastric bypassVolume-safety outcomes

Identifiers

PMID34471980
OpenAlexW3198190117

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.