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Surgical Endoscopy

Published in:

01-06-2016

Early hospital readmission after bariatric surgery

Authors: Mustafa W. Aman, Miloslawa Stem, Michael A. Schweitzer, Thomas H. Magnuson, Anne O. Lidor

Published in: Surgical Endoscopy | Issue 6/2016

Abstract

Background

With the rise in bariatric procedures being performed nationwide and the growing focus on quality and outcome measures, reducing early hospital readmission (EHR) rates has garnered great clinical interest. The aim of this study was to identify the incidence, reasons, and risk factors for EHR after bariatric surgery.

Methods

Using American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) dataset (2012–2013), patients with a diagnosis of obesity and body mass index ≥35 who underwent bariatric surgery were identified. EHR was defined as at least one hospitalization within 30 days of bariatric procedure. The association between readmission and patient factors was assessed using multivariable logistic regression analysis. In addition, reasons for readmission were sought.

Results

A total of 36,042 patients were identified. The overall EHR rate was 4.70 % [laparoscopic (lap) adjustable band 1.87 %, lap gastric bypass (GBP) 5.94 %, open GBP 7.86 %, and sleeve gastrectomy 3.73 %], and it occurred at the median of 11 days postoperatively. The rate of EHR significantly decreased from 2012 to 2013 (5.15 vs. 4.32 %, p < 0.001). The median age and BMI were 44 years and 44.7 kg/m², respectively, 78.99 % were female, and 70.78 % were white. The most common reason for readmission was nausea/vomiting (12.95 %), followed by abdominal pain (11.75 %) and dehydration (10.54 %). On multivariable analysis, factors most strongly associated with readmission were procedure type (lap band: reference; open GBP: OR 3.78, 95 % CI 2.47–5.80; lap GBP 3.18, 2.39–4.22; sleeve gastrectomy: 2.03, 1.52–2.71; all p < 0.001), steroid use (1.82, 1.33–2.48, p < 0.001), pre-discharge complication (1.64, 1.20–2.24, p < 0.001), and black population (1.51, 1.34–1.71, p < 0.001).

Conclusions

Bariatric centers should consider implementing standardized protocols for outpatient monitoring of patients identified to be at high risk of experiencing early readmission, which in turn would decrease overall costs and improve quality of care.

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Title: Early hospital readmission after bariatric surgery
Authors: Mustafa W. Aman
Miloslawa Stem
Michael A. Schweitzer
Thomas H. Magnuson
Anne O. Lidor
Publication date: 01-06-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 6/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4483-4

At a glance: The STEP trials

Springer Medicine

Early hospital readmission after bariatric surgery

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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