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Published in: Surgical Endoscopy 5/2016

01-05-2016

30-Day readmission after bariatric surgery in a publicly funded regionalized center of excellence system

Authors: Aristithes G. Doumouras, Fady Saleh, Dennis Hong

Published in: Surgical Endoscopy | Issue 5/2016

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Abstract

Background

Avoidable readmission after surgery is a major burden on healthcare resources and is common after major surgery. Bariatric surgery is one of the most common surgical procedures in North America, and there is a paucity of strategies to prevent readmission. Strategies for prevention must first identify actual risk factors before interventions can be designed.

Methods

Our objective was to evaluate the readmission rate, characteristics of readmitted patients, and factors associated with readmission. We performed a population-based cohort study that included all patients who received a Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) procedure in Ontario from April 2009 until March 2012 for the purposes of weight loss. Data were derived from the Canadian Institute for Health Information Discharge Abstract Database and Hospital Morbidity Database.

Results

Over 3 years, 5007 procedures (91.7 % RYGB, 8.1 % SG) were performed with an overall 30-day readmission rate of 6.1 %. Readmission stays of 72 h or less accounted for 83 % of the cohort. The most common reasons for readmission were: infectious complications (24.6 %), pain (16.4 %) nausea/vomiting (11.5 %), bleeding complications (11.5 %), obstruction (5.6 %). A complication during initial admission OR 2.07 (95 % CI 1.44–2.97; P value < 0.001) and a length of stay greater than 2 days OR 1.40 (95 % CI 1.07–1.84; P value = 0.013) were independent predictors of readmission within 30 days.

Conclusion

The readmission rate after bariatric surgery in Ontario is similar to other major population-based bariatric surgery programs. Complications on initial admission and prolonged length of stay were independent predictors of readmission. Considering a large proportion of the readmissions were short term, future research into potential measures to prevent these readmissions is essential.
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Metadata
Title
30-Day readmission after bariatric surgery in a publicly funded regionalized center of excellence system
Authors
Aristithes G. Doumouras
Fady Saleh
Dennis Hong
Publication date
01-05-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 5/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4455-8

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