Published in:
01-02-2017
Early discharge in the bariatric population does not increase post-discharge resource utilization
Published in: Surgical Endoscopy | Issue 2/2017
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Introduction
There is a trend toward shorter-stay bariatric surgery. However, reducing LOS may increase complications and post-discharge resource utilization. Our goal was to compare outcomes before and after implementation of short-stay bariatric surgery.
Methods and procedures
A retrospective chart review of a single-surgeon series of laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB). The two cohorts “target discharge POD 1” and “target discharge POD 2” were analyzed for on time discharges (feasibility) and complications. Patients who were successfully discharged in each cohort were further analyzed for post-discharge resource utilization.
Results
Early discharge was initiated in November of 2014 with 107 patients identified in this group. An additional 107 patients from those immediately preceding represented the target DC POD 2 group. The target DC POD 2 patients had a significantly higher percentage of patients who met their target LOS. The SD group (overall and LRYGB) had a significantly higher rate of hospital readmissions; this was the only significant difference in primary outcomes between the two groups. There was no difference in mortality, leaks or reoperation.
Conclusions
This study suggests that short-stay bariatric surgery is feasible and safe. Reducing the LOS from 2 to 1 day did not significantly increase the rate of hospital readmissions, ED visits or patient calls to our office. Further research is necessary to determine whether LOS can be further abbreviated to allow outpatient LSG and LRYGB.