Background

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) tracks 30 day outcomes of bariatric patients, but only at accredited centers. Presently, these cases are not broken down by state. We proposed using the inpatient and outpatient administrative databases in Texas to examine both the numbers and trends of bariatric surgery in Texas.

Methods

The Texas Inpatient Public Use Data File (IPUDF) and the Texas Outpatient Public Data File (OPUDF) were examined for the years 2013-2017. Patients undergoing adjustable gastric banding (AGB), sleeve gastrectomy (SG), gastric bypass (GB), duodenal switch and revisions of bariatric surgery were included.

Results

There were 105,199 bariatric cases performed in Texas from 2013-2017. There were 173 centers performing bariatric surgery. The most common operation performed was the sleeve gastrectomy at 73,663 cases (70% of total). Gastric bypasses were second at 22,890 cases. During this time period, AGB almost disappeared dropping from 2,090 cases in 2013 to 115 cases in 2017, with removal of 2,097 AGB in the study period in the OPUDF. There was a lower growth rate of the number of SG in the IPUDF with a large increase in SG performed with outpatient status, while GB remained relatively stable.

Conclusions

Rates of bariatric surgery in Texas are increasing slowly. The dominant procedure is the SG with a trend towards outpatient status. There are 90 more hospitals and surgery centers performing bariatric surgery than the 83 MBSAQIP accredited centers, calling into question the generalizability of that data.