Maria C Mora-Pinzon1, Dana Henkel2, Richard E Miller3, Patrick L Remington1, Jon C Gould4, Shanu N Kothari5, Luke M Funk6. 1. Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI. 2. Department of Surgery, University of Wisconsin-Madison, Madison, WI. 3. Wisconsin Department of Health Services, Madison, WI. 4. Department of Surgery, Medical College of Wisconsin, Milwaukee, WI. 5. Department of Surgery, Gundersen Health System, La Crosse, WI. 6. Department of Surgery, University of Wisconsin-Madison, Madison, WI; Department of Surgery, William S. Middleton VA Hospital, Madison, WI. Electronic address: funk@surgery.wisc.edu.
Abstract
BACKGROUND: Data are limited regarding emergency department visits and readmission rates beyond 30 days after bariatric surgery. We analyzed emergency department visits and readmissions to all facilities in Wisconsin within 1 year of bariatric surgery and identified their predictors. METHODS: All adults who underwent a laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy from 2011-2014 were identified. Bivariate associations between patient/hospital factors and emergency department visits/readmissions were examined, and factors significant at P < .1 were included in multivariable logistic regression models. RESULTS: Within 1 year of bariatric surgery, 36.9% of emergency department visits and 60.3% of readmissions were to the same institution in which bariatric surgery was performed. The frequency of emergency department visits ranged from 10.7% (postoperative days 0-30) to 5.7% (postoperative days 181-270). Readmission rates ranged from 4.4% (postoperative days 0-30) to 2.7% (postoperative days 91-180). Readmission within 1 year was associated with male sex, Roux-en-Y gastric bypass, ≥4 comorbidities, Medicare insurance, teaching hospitals, and inpatient complications (all P < .05). CONCLUSION: Emergency department visits and readmissions persist throughout the first year at a relatively steady rate after 30 days and often do not occur where bariatric surgery was performed. Quality improvement efforts targeting these patients may improve outcomes and decrease hospital resource utilization. Published by Elsevier Inc.
BACKGROUND: Data are limited regarding emergency department visits and readmission rates beyond 30 days after bariatric surgery. We analyzed emergency department visits and readmissions to all facilities in Wisconsin within 1 year of bariatric surgery and identified their predictors. METHODS: All adults who underwent a laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy from 2011-2014 were identified. Bivariate associations between patient/hospital factors and emergency department visits/readmissions were examined, and factors significant at P < .1 were included in multivariable logistic regression models. RESULTS: Within 1 year of bariatric surgery, 36.9% of emergency department visits and 60.3% of readmissions were to the same institution in which bariatric surgery was performed. The frequency of emergency department visits ranged from 10.7% (postoperative days 0-30) to 5.7% (postoperative days 181-270). Readmission rates ranged from 4.4% (postoperative days 0-30) to 2.7% (postoperative days 91-180). Readmission within 1 year was associated with male sex, Roux-en-Y gastric bypass, ≥4 comorbidities, Medicare insurance, teaching hospitals, and inpatient complications (all P < .05). CONCLUSION: Emergency department visits and readmissions persist throughout the first year at a relatively steady rate after 30 days and often do not occur where bariatric surgery was performed. Quality improvement efforts targeting these patients may improve outcomes and decrease hospital resource utilization. Published by Elsevier Inc.
Authors: Natalie Liu; Manasa Venkatesh; Bret M Hanlon; Anna Muraveva; Morgan K Johnson; Lawrence P Hanrahan; Luke M Funk Journal: Ann Surg Open Date: 2021-01-07