National prevalence, causes, and risk factors for bariatric surgery readmissions

Am J Surg. 2016 Jul;212(1):76-80. doi: 10.1016/j.amjsurg.2016.01.023. Epub 2016 Mar 19.

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.

Keywords: Bariatric surgery; Obesity; Readmissions.

MeSH terms

  • Adult
  • Age Distribution
  • Bariatric Surgery / adverse effects*
  • Bariatric Surgery / methods*
  • Body Mass Index
  • Databases, Factual
  • Female
  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Gastric Bypass / adverse effects
  • Gastric Bypass / methods
  • Gastroplasty / adverse effects
  • Gastroplasty / methods
  • Humans
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity, Morbid / diagnosis
  • Obesity, Morbid / surgery*
  • Outcome Assessment, Health Care
  • Patient Readmission / statistics & numerical data*
  • Postoperative Complications / physiopathology
  • Postoperative Complications / surgery
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • United States