Trit Garg1, Ulysses Rosas1, Homero Rivas1, Dan Azagury1, John M Morton2. 1. Department of Surgery, Section of Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA. 2. Department of Surgery, Section of Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA. Electronic address: morton@stanford.edu.
Abstract
BACKGROUND: Readmissions are often used as a quality metric particularly in bariatric surgery. METHODS: Laparoscopic Roux en Y gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy were identified using Current Procedure Terminology codes in the 2012 National Surgical Quality Improvement Program public use file. RESULTS: A total of 18,296 patients were included, 10,080 (55.1%) were laparoscopic Roux en Y gastric bypass, 1,829 (10.0%) were laparoscopic adjustable gastric banding, and 6,387 (34.9%) were laparoscopic sleeve gastrectomy. Among all patients, 955 (5.22%) were readmitted. Patients with readmissions had a higher proportion of body mass index greater than 50 (30.2% vs 24.6%, P < .001), higher index operative time (132 minutes vs 115, P < .001) and greater proportion with length of stay greater than 4 days (9.57% vs 3.36%, P < .001). Readmitted patients were more likely to have diabetes (31.1% vs 27.7%, P = .02), chronic obstructive pulmonary disease (2.63% vs 1.72%, P = .04), and hypertension (54.5% vs 50.8%, P = .03). Overall, 40.6% of readmitted patients had a complication. Common readmissions were gastrointestinal-related (45.0%), dietary (33.5%), and bleeding (6.57%). Readmission was independently associated with African-American race (odds ratio [OR] = 1.53, P = .02), complication (OR = 11.3, 95%, P < .001), and resident involvement (OR = .53, P = .04). CONCLUSIONS: A 30-day readmission after bariatric surgery is prevalent and closely associated with complications.
BACKGROUND: Readmissions are often used as a quality metric particularly in bariatric surgery. METHODS: Laparoscopic Roux en Y gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy were identified using Current Procedure Terminology codes in the 2012 National Surgical Quality Improvement Program public use file. RESULTS: A total of 18,296 patients were included, 10,080 (55.1%) were laparoscopic Roux en Y gastric bypass, 1,829 (10.0%) were laparoscopic adjustable gastric banding, and 6,387 (34.9%) were laparoscopic sleeve gastrectomy. Among all patients, 955 (5.22%) were readmitted. Patients with readmissions had a higher proportion of body mass index greater than 50 (30.2% vs 24.6%, P < .001), higher index operative time (132 minutes vs 115, P < .001) and greater proportion with length of stay greater than 4 days (9.57% vs 3.36%, P < .001). Readmitted patients were more likely to have diabetes (31.1% vs 27.7%, P = .02), chronic obstructive pulmonary disease (2.63% vs 1.72%, P = .04), and hypertension (54.5% vs 50.8%, P = .03). Overall, 40.6% of readmitted patients had a complication. Common readmissions were gastrointestinal-related (45.0%), dietary (33.5%), and bleeding (6.57%). Readmission was independently associated with African-American race (odds ratio [OR] = 1.53, P = .02), complication (OR = 11.3, 95%, P < .001), and resident involvement (OR = .53, P = .04). CONCLUSIONS: A 30-day readmission after bariatric surgery is prevalent and closely associated with complications.
Authors: Jerry T Dang; Iran Tavakoli; Noah Switzer; Valentin Mocanu; Xinzhe Shi; Chris de Gara; Daniel W Birch; Shahzeer Karmali Journal: Can J Surg Date: 2020-04-17 Impact factor: 2.089
Authors: Elisa Morales-Marroquin; Luyu Xie; Luigi Meneghini; Nestor de la Cruz-Muñoz; Jaime P Almandoz; Sunil M Mathew; Benjamin E Schneider; Sarah E Messiah Journal: Obesity (Silver Spring) Date: 2020-11-20 Impact factor: 9.298