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Published in: Obesity Surgery 2/2021

01-02-2021 | Bariatric Surgery | Original Contributions

Gastroesophageal Reflux Predicts Utilization of Dehydration Treatments After Bariatric Surgery

Authors: Keri A. Seymour, Megan C. Turner, Maragatha Kuchibhatla, Ranjan Sudan

Published in: Obesity Surgery | Issue 2/2021

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Abstract

Background

Dehydration treatments (DT) provide intravenous fluids to patients in the outpatient setting; however, the utilization of DT is not well-described. We characterize the cohort receiving DT, the first year it was recorded in a bariatric-specific database.

Setting

A retrospective cohort analysis of patients undergoing bariatric surgery between January 1, 2016, and December 31, 2016, in 791 centers in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data file.

Methods

Patients ≥ 18 years with a body mass index (BMI) ≥ 35 kg/m2 who underwent laparoscopic adjustable gastric band (LAGB), sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (LRYGB), and biliopancreatic diversion with duodenal switch (LBPD/DS) were identified. Unadjusted and adjusted rates of DT were analyzed. In addition, adjusted rates and indication for readmission were reviewed.

Results

The overall rate of dehydration treatments was 3.5% for the 141,748 bariatric surgery cases identified. Patient comorbidities of gastroesophageal reflux (GERD) (odds ratio (OR) 1.49; 95% CI, 1.40–1.59), insulin-dependent diabetes (OR = 1.19; 95% CI, 1.07–1.33), and LRYGB (OR = 1.45; 95% CI, 1.36–1.54) were associated with higher odds of DT. DT only had the highest odds of readmission (OR = 6.22; 95% CI, 5.55–6.98) compared to other outpatient visits. Nausea and vomiting, or fluid, electrolyte, or nutritional depletion was the most common indication for readmission in all groups.

Conclusions

Patients with GERD utilized dehydration treatments after bariatric surgery. DT was highly associated with readmissions, and a better understanding of the clinical application of DT will allow bariatric centers to develop programs to further optimize outpatient treatments.
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Literature
2.
go back to reference Morton J. The first metabolic and bariatric surgery accreditation and quality improvement program quality initiative: decreasing readmissions through opportunities provided. Surg Obes Relat Dis. 2014;10(3):377–8.CrossRef Morton J. The first metabolic and bariatric surgery accreditation and quality improvement program quality initiative: decreasing readmissions through opportunities provided. Surg Obes Relat Dis. 2014;10(3):377–8.CrossRef
3.
go back to reference Jalilvand A, Suzo A, Hornor M, et al. Impact of care coaching on hospital length of stay, readmission rates, postdischarge phone calls, and patient satisfaction after bariatric surgery. Surg Obes Relat Dis. 2016;12(9):1737–45.CrossRef Jalilvand A, Suzo A, Hornor M, et al. Impact of care coaching on hospital length of stay, readmission rates, postdischarge phone calls, and patient satisfaction after bariatric surgery. Surg Obes Relat Dis. 2016;12(9):1737–45.CrossRef
4.
go back to reference Hutter M. Why readmissions matter. Surg Obes Relat Dis. 2014;10(3):379–81.CrossRef Hutter M. Why readmissions matter. Surg Obes Relat Dis. 2014;10(3):379–81.CrossRef
5.
go back to reference Khorgami Z, Andalib A, Aminian A, et al. Predictors of readmission after laparoscopic gastric bypass and sleeve gastrectomy: a comparative analysis of ACS-NSQIP database. Surg Endosc. 2016;30(6):2342–50.CrossRef Khorgami Z, Andalib A, Aminian A, et al. Predictors of readmission after laparoscopic gastric bypass and sleeve gastrectomy: a comparative analysis of ACS-NSQIP database. Surg Endosc. 2016;30(6):2342–50.CrossRef
6.
go back to reference Merkow RP, Ju MH, Chung JW, et al. Underlying reasons associated with hospital readmission following surgery in the United States. JAMA. 2015;313(5):483–95.CrossRef Merkow RP, Ju MH, Chung JW, et al. Underlying reasons associated with hospital readmission following surgery in the United States. JAMA. 2015;313(5):483–95.CrossRef
7.
go back to reference Sippey M, Kasten KR, Chapman WH, et al. 30-day readmissions after sleeve gastrectomy versus Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2016;12(5):991–6.CrossRef Sippey M, Kasten KR, Chapman WH, et al. 30-day readmissions after sleeve gastrectomy versus Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2016;12(5):991–6.CrossRef
8.
go back to reference Berger ER, Huffman KM, Fraker T, et al. Prevalence and risk factors for bariatric surgery readmissions: findings from 130,007 admissions in the metabolic and bariatric surgery accreditation and quality improvement program. Ann Surg. 2018;267(1):122–31.CrossRef Berger ER, Huffman KM, Fraker T, et al. Prevalence and risk factors for bariatric surgery readmissions: findings from 130,007 admissions in the metabolic and bariatric surgery accreditation and quality improvement program. Ann Surg. 2018;267(1):122–31.CrossRef
9.
go back to reference Goldfield NI, McCullough EC, Hughes JS, et al. Identifying potentially preventable readmissions. Health Care Financ Rev. 2008;30(1):75–91.PubMedPubMedCentral Goldfield NI, McCullough EC, Hughes JS, et al. Identifying potentially preventable readmissions. Health Care Financ Rev. 2008;30(1):75–91.PubMedPubMedCentral
11.
go back to reference Mora-Pinzon MC, Henkel D, Miller RE, et al. Emergency department visits and readmissions within 1 year of bariatric surgery: a statewide analysis using hospital discharge records. Surgery. 2017;162(5):1155–62.CrossRef Mora-Pinzon MC, Henkel D, Miller RE, et al. Emergency department visits and readmissions within 1 year of bariatric surgery: a statewide analysis using hospital discharge records. Surgery. 2017;162(5):1155–62.CrossRef
12.
go back to reference Surve A, Zaveri H, Cottam D, et al. A retrospective comparison of biliopancreatic diversion with duodenal switch with single anastomosis duodenal switch (SIPS-stomach intestinal pylorus sparing surgery) at a single institution with two year follow-up. Surg Obes Relat Dis. 2017;13(3):415–22.CrossRef Surve A, Zaveri H, Cottam D, et al. A retrospective comparison of biliopancreatic diversion with duodenal switch with single anastomosis duodenal switch (SIPS-stomach intestinal pylorus sparing surgery) at a single institution with two year follow-up. Surg Obes Relat Dis. 2017;13(3):415–22.CrossRef
13.
go back to reference Weller WE, Rosati C, Hannan EL. Relationship between surgeon and hospital volume and readmission after bariatric operation. J Am Coll Surg. 2007;204(3):383–91.CrossRef Weller WE, Rosati C, Hannan EL. Relationship between surgeon and hospital volume and readmission after bariatric operation. J Am Coll Surg. 2007;204(3):383–91.CrossRef
14.
go back to reference Garg T, Rosas U, Rivas H, et al. National prevalence, causes, and risk factors for bariatric surgery readmissions. Am J Surg. 2016;212(1):76–80.CrossRef Garg T, Rosas U, Rivas H, et al. National prevalence, causes, and risk factors for bariatric surgery readmissions. Am J Surg. 2016;212(1):76–80.CrossRef
15.
go back to reference Telem DA, Yang J, Altieri M, et al. Rates and risk factors for unplanned emergency department utilization and hospital readmission following bariatric surgery. Ann Surg. 2016;263(5):956–60.CrossRef Telem DA, Yang J, Altieri M, et al. Rates and risk factors for unplanned emergency department utilization and hospital readmission following bariatric surgery. Ann Surg. 2016;263(5):956–60.CrossRef
16.
go back to reference Soricelli E, Iossa A, Casella G, et al. Sleeve gastrectomy and crural repair in obese patients with gastroesophageal reflux disease and/or hiatal hernia. Surg Obes Relat Dis. 2013;9(3):356–61.CrossRef Soricelli E, Iossa A, Casella G, et al. Sleeve gastrectomy and crural repair in obese patients with gastroesophageal reflux disease and/or hiatal hernia. Surg Obes Relat Dis. 2013;9(3):356–61.CrossRef
17.
go back to reference Rebecchi F, Allaix ME, Giaccone C, et al. Gastroesophageal reflux disease and laparoscopic sleeve gastrectomy: a physiopathologic evaluation. Ann Surg. 2014;260(5):909–14. discussion 14-5CrossRef Rebecchi F, Allaix ME, Giaccone C, et al. Gastroesophageal reflux disease and laparoscopic sleeve gastrectomy: a physiopathologic evaluation. Ann Surg. 2014;260(5):909–14. discussion 14-5CrossRef
18.
go back to reference Borza T, Oerline MK, Skolarus TA, et al. Association of the hospital readmissions reduction program with surgical readmissions. JAMA Surg. 2018;153(3):243–50. Borza T, Oerline MK, Skolarus TA, et al. Association of the hospital readmissions reduction program with surgical readmissions. JAMA Surg. 2018;153(3):243–50.
19.
go back to reference Fortes MB, Owen JA, Raymond-Barker P, et al. Is this elderly patient dehydrated? Diagnostic accuracy of hydration assessment using physical signs, urine, and saliva markers. J Am Med Dir Assoc. 2015;16(3):221–8.CrossRef Fortes MB, Owen JA, Raymond-Barker P, et al. Is this elderly patient dehydrated? Diagnostic accuracy of hydration assessment using physical signs, urine, and saliva markers. J Am Med Dir Assoc. 2015;16(3):221–8.CrossRef
20.
go back to reference Garg T, Rosas U, Rogan D, et al. Characterizing readmissions after bariatric surgery. J Gastrointest Surg. 2016;20(11):1797–801.CrossRef Garg T, Rosas U, Rogan D, et al. Characterizing readmissions after bariatric surgery. J Gastrointest Surg. 2016;20(11):1797–801.CrossRef
21.
go back to reference Gabayan GZ, Doyle B, Liang LJ, et al. Who has an unsuccessful observation care stay? Healthcare (Basel). 2018;6(4):138. Gabayan GZ, Doyle B, Liang LJ, et al. Who has an unsuccessful observation care stay? Healthcare (Basel). 2018;6(4):138.
22.
go back to reference Aman MW, Stem M, Schweitzer MA, et al. Early hospital readmission after bariatric surgery. Surg Endosc. 2016;30(6):2231–8.CrossRef Aman MW, Stem M, Schweitzer MA, et al. Early hospital readmission after bariatric surgery. Surg Endosc. 2016;30(6):2231–8.CrossRef
23.
go back to reference Thorell A, MacCormick AD, Awad S, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg. 2016;40(9):2065–83.CrossRef Thorell A, MacCormick AD, Awad S, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg. 2016;40(9):2065–83.CrossRef
24.
go back to reference Macht R, Cassidy R, Cabral H, et al. Evaluating organizational factors associated with postoperative bariatric surgery readmissions. Surg Obes Relat Dis. 2017;13(6):1004–9.CrossRef Macht R, Cassidy R, Cabral H, et al. Evaluating organizational factors associated with postoperative bariatric surgery readmissions. Surg Obes Relat Dis. 2017;13(6):1004–9.CrossRef
25.
go back to reference Chen SY, Stem M, Schweitzer MA, et al. Assessment of postdischarge complications after bariatric surgery: a National Surgical Quality Improvement Program analysis. Surgery. 2015;158(3):777–86.CrossRef Chen SY, Stem M, Schweitzer MA, et al. Assessment of postdischarge complications after bariatric surgery: a National Surgical Quality Improvement Program analysis. Surgery. 2015;158(3):777–86.CrossRef
26.
go back to reference Kim J, American Society for M, Bariatric Surgery Clinical Issues C. American Society for Metabolic and Bariatric Surgery statement on single-anastomosis duodenal switch. Surg Obes Relat Dis. 2016;12(5):944–5.CrossRef Kim J, American Society for M, Bariatric Surgery Clinical Issues C. American Society for Metabolic and Bariatric Surgery statement on single-anastomosis duodenal switch. Surg Obes Relat Dis. 2016;12(5):944–5.CrossRef
Metadata
Title
Gastroesophageal Reflux Predicts Utilization of Dehydration Treatments After Bariatric Surgery
Authors
Keri A. Seymour
Megan C. Turner
Maragatha Kuchibhatla
Ranjan Sudan
Publication date
01-02-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-05043-9

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