Impact of same-day sleeve gastrectomy surgery on postoperative emergency department visits: analysis from the Michigan Bariatric Surgery Collaborative

Background: Same-day discharge after sleeve gastrectomy (SDDSG) is being performed in select patient populations with increased regularity since 2020.

Objectives: To evaluate the impact of SDDSG on emergency department (ED) visits.

Setting: Academic and private practice bariatric surgery programs participating in a statewide quality improvement collaborative.

Methods: Using a statewide bariatric specific data registry, all patients undergoing SDDSG between 2020 and 2023 were identified (n = 984). Rates of 30-day ED visits and complications were compared between SDDSG and a 2:1 propensity-matched cohort with a 1-2-day hospital length of stay (n = 1968).

Results: The mean age and body mass index of SDDSG patients were 41.7 years and 45.9, respectively. When compared to the matched cohort, SDDSG patients had higher rates of ED visits (9.2% versus 6.2%, P = .0029), were more likely to present to ED earlier (10.3 days versus 12.9 days, P = .0118), and were less likely to require hospital admission (87.8% versus 71.1%, P < .0037), even though the overall complication rates were similar (4.7% versus 3.7%, P = .2087). The most common reason for an ED visit after SDDSG was nausea, vomiting, and dehydration (58.9% versus 66.9%, P = .2294), and the most common day to present to the ED was Friday (20.0% versus 20.7%, P = .9061), which was similar between groups.

Conclusions: Despite having similar complication rates, patients undergoing SDDSG were more likely to present to the ED after surgery when compared to a matched cohort of patients with a 1-2-day hospital stay.