Increasing Utilization of Laparoscopic Gastric Banding in the Adolescent: Data from Academic Medical Centers, 2002-2009

2011 ◽  
Vol 77 (11) ◽  
pp. 1510-1514 ◽  
Author(s):  
Ninh T. Nguyen ◽  
Farah Karipineni ◽  
Hossein Masoomi ◽  
Kelly Laugenour ◽  
Kevin Reavis ◽  
...  

Bariatric surgery in the adolescent continues to be a controversial topic. This study compared the utilization and perioperative outcomes of adolescent bariatric surgery performed at academic centers from 2002 to 2006 versus 2007 to 2009. We obtained data from the University HealthSystem Consortium for all adolescent patients (ages 12-18 years) who underwent bariatric surgery for the treatment of morbid obesity between 2002 and 2009. Outcomes including type of procedure, characteristics, length of stay, 30-day readmission, morbidity, and in-hospital mortality were compared between the two time periods. From 2007 to 2009, 340 adolescents underwent bariatric surgery at 63 academic hospitals. The mean number of adolescent bariatric procedures performed/year increased from 61.8 in 2002 to 2006 to 113.3 procedures/year in 2007 to 2009. There was an increase in utilization of laparoscopic gastric banding from 29 per cent to 50 per cent with a decrease in utilization of gastric bypass from 62 per cent to 48 per cent, respectively. For 2007 to 2009, the overall morbidity was 2.9 per cent with a 30-day readmission of 1.5 per cent and an in-hospital mortality of 0 per cent. Within the context of academic medical centers, adolescent bariatric surgery is associated with low morbidity and no mortality. Compared with 2002 to 2006, there has been an increase in the number of adolescent bariatric operations with increase in utilization of the laparoscopic gastric banding.

2016 ◽  
Vol 11 (12) ◽  
pp. 847-852 ◽  
Author(s):  
Mary E. Anderson ◽  
Jeffrey J. Glasheen ◽  
Debra Anoff ◽  
Read Pierce ◽  
Molly Lane ◽  
...  

2004 ◽  
Vol 8 (7) ◽  
pp. 856-861 ◽  
Author(s):  
N NGUYEN ◽  
C MOORE ◽  
C STEVENS ◽  
S CHALIFOUX ◽  
S MAVANDADI ◽  
...  

Author(s):  
Ninh T. Nguyen ◽  
Mahbod Paya ◽  
C Melinda Stevens ◽  
Shahrzad Mavandadi ◽  
Kambiz Zainabadi ◽  
...  

2016 ◽  
Vol 26 (3) ◽  
pp. 696-700 ◽  
Author(s):  
Baiyu Yang ◽  
Hannah P. Yang ◽  
Kristy K. Ward ◽  
Vikrant V. Sahasrabuddhe ◽  
Katherine A. McGlynn

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 382-382
Author(s):  
S. Claiborne Johnston ◽  
Leslie A Gillum

P235 Background: Data supporting the efficacy of stroke center characteristics are limited. Methods: A questionnaire detailing stroke treatment practices was sent to 42 academic medical centers in the University Health Systems Consortium participating in a quality improvement project. In-hospital mortality of all emergency-department admissions for ischemic stroke at these institutions was evaluated in a large administrative database from 1997 through 1999. We used a multivariable method called generalized estimating equations, which broadens confidence intervals to adjust for clustering of variables at institutions. Using this technique, institutional characteristics were evaluated as predictors of in-hospital mortality after adjusting for age, gender, race, hospital treatment volume of ischemic stroke, and admission status (emergent, urgent, elective). Results: Thirty-two institutions completed the questionnaire and 29 of these were included in the administrative database. In-hospital deaths occurred in 758 (7.0%) of the 10,880 ischemic strokes admitted through the emergency department. In-hospital deaths were less frequent at hospitals with a vascular neurologist (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.36–0.74, p<0.001), and at those with guidelines stating that only neurologists could administer tPA (OR 0.65, 95% CI 0.49–0.88, p=0.004). There was a trend toward fewer deaths at hospitals with a dedicated stroke team available by pager (OR 0.76, 95% CI 0.56–1.04, p=0.09). The presence of a dedicated neurological intensive care unit, stroke unit, and written clinical pathway for stroke were not significantly associated with in-hospital death. Conclusions: Academic medical centers with a vascular neurologist and those with written guidelines limiting tPA administration to neurologists had lower rates of in-hospital mortality for ischemic stroke patients.


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