Title :

Impact of Centralized Management of Bariatric Surgery Complications on 90-day Mortality.

Author(s) :

Caiazzo, Robert [Auteur]
Recherche translationnelle sur le diabète (EGID) - U1190
Baud, Gregory [Auteur]

Clement, Guillaume [Auteur]
Lenne, Xavier [Auteur]
Torres, Fanelly [Auteur]
Recherche translationnelle sur le diabète (EGID) - U1190
Dezfoulian, Guelareh [Auteur]
Lebuffe, Gilles [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - EA 7365
Kipnis, Eric [Auteur]
Recherche translationnelle : relations hôte-pathogènes - EA 7366
Dervaux, Benoit [Auteur]
Santé publique : épidémiologie et qualité des soins - EA 2694
Pattou, Francois [Auteur]
Recherche translationnelle sur le diabète (EGID) - U1190

Journal title :

Annals of surgery

Abbreviated title :

Ann. Surg.

Publication date :

2018

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND AND AIMS: The potential benefit of the centralization of Bariatric surgery (BS) remains debated. The aim of this study was to evaluate the impact on 90-day mortality of an innovative organization aiming at ...
Show more >BACKGROUND AND AIMS: The potential benefit of the centralization of Bariatric surgery (BS) remains debated. The aim of this study was to evaluate the impact on 90-day mortality of an innovative organization aiming at centralizing the care of severe postoperative complications of BS. STUDY DESIGN: The centralization of care for postoperative complication after BS was implemented by French Authorities in 2013 in the Nord-Pas-de-Calais Region, France. This unique formalized network (OSEAN), coordinated by 1 tertiary referral center, enrolled all regional institutions performing bariatric surgery. Data were extracted from the medico-administrative database providing information on all patients undergoing BS between 2009 and 2016 in OSEAN (n = 22,928) and in Rest of France (n = 288,942). The primary outcome was the evolution of 90-day mortality before and after the implementation of this policy. Rest of France was used as a control group to adjust the results to improvement with time of BS outcomes. RESULTS: The numbers of primary procedure and reoperations increased similarly before and after 2013 within OSEAN and in Rest of France. The 90-day mortality rate became significantly lower within OSEAN than in the rest of France after 2013 (0.03% vs 0.08%, P < 0.01). This difference was confirmed in multivariate analysis after adjustment to the procedure specific mortality (P < 0.04). The reduction of 90-day mortality was most visible for sleeve gastrectomy. CONCLUSION: The implementation of centralized care for early postoperative complications after BS in OSEAN was associated with reduced 90-day mortality. Our results indicate that this reduction was not due to a lower incidence of complications but to the improvement of their management.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille
Inserm

Collections :

• Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - EA 7365
• Recherche translationnelle : relations hôte-pathogènes - EA 7366
• Recherche translationnelle sur le diabète (EGID) - U1190
• Santé publique : épidémiologie et qualité des soins - EA 2694

Research team(s) :

Innovation/évaluation des médicaments injectables

Submission date :

2019-02-26T17:06:52Z