Sachit Sharma1, Muhammad Aziz2, Ishaan Vohra3, Faisal Kamal4, Ashu Acharya2, Zubair Khan5, Simcha Weissman6, Ali Nawras7. 1. Department of Medicine, University of Toledo Medical Center, Toledo, OH, USA. sachitsharma@outlook.com. 2. Department of Medicine, University of Toledo Medical Center, Toledo, OH, USA. 3. Department of Medicine, John H. Stroger Jr, Hospital of Cook County, Chicago, IL, USA. 4. Department of Gastroenterology, The University of Tennessee Health Science Center, Memphis, TN, USA. 5. Department of Gastroenterology, University of Texas Health Center at Houston, Houston, TX, USA. 6. Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA. 7. Department of Gastroenterology, The University of Toledo Medical Center, Toledo, OH, USA.
Abstract
BACKGROUND: Among various therapeutic options for morbid obesity, bariatric surgery (BS) is now considered one of the most effective methods of weight loss. We decided to perform an analysis to look at 30-day all-cause readmission and independent predictors of readmission in patients undergoing BS. METHODS: We queried the 2017 Nationwide Readmission Database (NRD) using ICD-10-CM diagnosis codes to identify all adult patients who underwent BS from January 1 to November 30, 2017. Outcomes assessed were 30-day readmission rates, mortality, length of stay (LOS) and hospitalization costs, and independent predictors of readmission. RESULTS: A total of 182,848 adult patients underwent BS during hospitalization in 2017, with in-hospital mortality rate of 0.52% (951). Of the patients discharged, 4.99% (9088) patients were readmitted within 30 days. The most common primary diagnosis at readmission was "Other complications of other bariatric surgery". When compared with index admission, readmitted patients had higher in-hospital mortality (0.52% vs 2.06%, p < 0.01), increased mean LOS (2.94 days vs 5.94 days, p < 0.01) but lower mean hospitalization charges ($67,763 vs $66,065, p < 0.01). Increasing age (HR 1.01, 95% CI: 1.006-1.014, p < 0.01), longer LOS (HR 1.01, 95% CI: 1.008-1.014, p < 0.01), higher comorbidity score (HR 1.15, 95% CI: 1.12-1.18, p < 0.01), CHF (HR 1.19, 95% CI: 1.01-1.42, p < 0.05), and AKI (HR 1.64, 95% CI: 1.34-2.02, p < 0.01) were independently associated with increased likelihood of 30-day readmission. CONCLUSION: This study shows that almost 5% patients undergoing bariatric surgery are readmitted within 30 days of discharge in the US. Further studies are needed to assess the high-risk populations to understand the reasons predisposing to early readmission.
BACKGROUND: Among various therapeutic options for morbid obesity, bariatric surgery (BS) is now considered one of the most effective methods of weight loss. We decided to perform an analysis to look at 30-day all-cause readmission and independent predictors of readmission in patients undergoing BS. METHODS: We queried the 2017 Nationwide Readmission Database (NRD) using ICD-10-CM diagnosis codes to identify all adult patients who underwent BS from January 1 to November 30, 2017. Outcomes assessed were 30-day readmission rates, mortality, length of stay (LOS) and hospitalization costs, and independent predictors of readmission. RESULTS: A total of 182,848 adult patients underwent BS during hospitalization in 2017, with in-hospital mortality rate of 0.52% (951). Of the patients discharged, 4.99% (9088) patients were readmitted within 30 days. The most common primary diagnosis at readmission was "Other complications of other bariatric surgery". When compared with index admission, readmitted patients had higher in-hospital mortality (0.52% vs 2.06%, p < 0.01), increased mean LOS (2.94 days vs 5.94 days, p < 0.01) but lower mean hospitalization charges ($67,763 vs $66,065, p < 0.01). Increasing age (HR 1.01, 95% CI: 1.006-1.014, p < 0.01), longer LOS (HR 1.01, 95% CI: 1.008-1.014, p < 0.01), higher comorbidity score (HR 1.15, 95% CI: 1.12-1.18, p < 0.01), CHF (HR 1.19, 95% CI: 1.01-1.42, p < 0.05), and AKI (HR 1.64, 95% CI: 1.34-2.02, p < 0.01) were independently associated with increased likelihood of 30-day readmission. CONCLUSION: This study shows that almost 5% patients undergoing bariatric surgery are readmitted within 30 days of discharge in the US. Further studies are needed to assess the high-risk populations to understand the reasons predisposing to early readmission.
Authors: S Huerta; D Heber; M P Sawicki; C D Liu; D Arthur; P Alexander; I Yip; Z P Li; E H Livingston Journal: Am Surg Date: 2001-12 Impact factor: 0.688