Result of a National Audit of Bariatric Surgery Performed at Academic Centers

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Abstract
Bariatric surgery has gained acceptance by the public, primary care physicians, and surgeons. The resulting exponential growth of bariatric surgery has increased scrutiny by third-party payers and the media regarding the safety of bariatric surgery. To date, the outcome of bariatric surgery has been derived from large, single-institution series reflecting practice of bariatric surgery at a few experienced centers.1-6 Although the reported mortality at these selected centers is low, a recent report that examined the outcome of gastric bypass using the Washington State Comprehensive Hospital Abstract Reporting System demonstrated that the 30-day mortality rate (1.9%) was higher than previously reported.7 Similarly in another study of 16 155 Medicare beneficiaries who underwent bariatric surgery, the 30-day mortality rate was reported as 2%.8 These reports bring into question the safety of bariatric surgery on the regional and national levels. Although the beneficial effects of bariatric surgery have been well documented, the higher perioperative death rate from these recent reports is concerning.