30-Day readmission after bariatric surgery in a publicly funded regionalized center of excellence system

Doumouras, Aristithes G.; Saleh, Fady; Hong, Dennis

doi:10.1007/s00464-015-4455-8

Cited by 32 publications

(24 citation statements)

References 29 publications

(87 reference statements)

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“…In another, patients who underwent LRYGB had 60% higher risk for readmission in the 30-day postoperative time period compared to those who underwent LSG [ 34 ]. Contrary to this, we and Doumouras et al did not observe similar relationship [ 26 ]. Operative time and intraoperative adverse events were also proved to increase risk of readmission [ 34 , 47 ].…”

Section: Discussioncontrasting

confidence: 99%

“…Recent study by Sippey et al reported an overall 30-day readmission rate after LSG or LRYGB of 5.1% [ 25 ]. Other authors reported readmission rates after those two procedures in the range of 1.87–14.16% [ 18 , 26 – 33 ]. Despite many authors reporting more common readmissions after LRYGB compared with LSG [ 25 , 27 , 28 , 34 ], one study documented higher rates after LSG [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

Major

Wysocki

Torbicz³

et al. 2017

OBES SURG

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BackgroundLaparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB) are most commonly performed bariatric procedures. Laparoscopic approach and enhanced recovery after surgery (ERAS) protocols managed to decrease length of hospital and morbidity. However, there are patients in whom, despite adherence to the protocol, the length of stay (LOS) remains longer than targeted. This study aimed to assess potential risk factors for prolonged LOS and readmissions.MethodsThe study was a prospective observation with a post-hoc analysis of bariatric patients in a tertiary referral university teaching hospital. Inclusion criteria were undergoing laparoscopic bariatric surgery. Exclusion criteria were occurrence of perioperative complications, prior bariatric procedures, and lack of necessary data. The primary endpoints were the evaluations of risk factors for prolonged LOS and readmissions.ResultsMedian LOS was 3 (2–4) days. LOS > 3 days occurred in 145 (29.47%) patients, 79 after LSG (25.82%) and 66 after LRYGB (35.48%; p = 0.008). Factors significantly prolonging LOS were low oral fluid intake, high intravenous volume of fluids administered on POD0, and every additional 50 km distance from habitual residence to bariatric center. The risk of hospital readmission rises with occurrence of intraoperative adverse events and low oral fluid intake on the day of surgery on.ConclusionsRisk factors for prolonged LOS are low oral fluid intake, high intravenous volume of fluids administered on POD0, and every additional 50 km distance from habitual residence. Risk factors for hospital readmission are intraoperative adverse events and low oral fluid intake on the day of surgery.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

Major

Wysocki

Torbicz³

et al. 2017

OBES SURG

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“…Postoperative bleeding that requires intervention occurs in up to 11% of cases in both the RYGB and SG. 23 Fortunately, 85% of patients are likely to stop without surgical intervention. 24 Patients with dysmetabolic syndrome X have a higher risk for bleeding.…”

Section: Early Complicationsmentioning

confidence: 99%

Early and late complications of bariatric operation

Lim

Beekley

Johnson

et al. 2018

Trauma Surg Acute Care Open

121

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Weight loss surgery is one of the fastest growing segments of the surgical discipline. As with all medical procedures, postoperative complications will occur. Acute care surgeons need to be familiar with the common problems and their management. Although general surgical principles generally apply, diagnoses specific to the various bariatric operations must be considered. There are anatomic considerations which alter management priorities and options for these patients in many instances. These problems present both early or late in the postoperative course. Bariatric operations, in many instances, result in permanent alteration of a patient’s anatomy, which can lead to complications at any time during the course of a patient’s life. Acute care surgeons diagnosing surgical emergencies in postbariatric operation patients must be familiar with the type of surgery performed, as well as the common postbariatric surgical emergencies. In addition, surgeons must not overlook the common causes of an acute surgical abdomen—acute appendicitis, acute diverticulitis, acute pancreatitis, and gallstone disease—for these are still among the most common etiologies of abdominal pathology in these patients.

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“…Telem et al [34] reported that 17.5% of patients who underwent primary bariatric surgery had unplanned ED appearances. Doumouras et al [35] reported a readmission rate of 6.1% over a period of 3 years. Saunders et al [36] reported 1-year readmission rate of 18.8%.…”

Section: Introductionmentioning

confidence: 99%

“…According to international studies, several predictors for hospital readmission or ED visits after bariatric surgery were identified. The most important predictors for readmission were found to be age, sex, BMI, diabetes, steroid use, hypertension, type of procedure, and operative time [28,35,37]. In addition, the surgical procedure type has been associated with postoperative ED visits [31].…”

Section: Introductionmentioning

confidence: 99%

Readmissions and Emergency Department Visits after Bariatric Surgery at Saudi Arabian Hospital: The Rates, Reasons, and Risk Factors

et al. 2017

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Background: Saudi Arabian hospital readmissions and emergency department (ED) visits following bariatric surgery and discharge have never been investigated. This study aimed to evaluate the rates and reasons of hospital readmissions and ED visits related to surgical weight loss interventions at the King Abdulaziz Medical City - Riyadh. Methods: We conducted a retrospective cohort study on 301 patients who underwent bariatric surgery between January 2011 and July 2016. We reviewed patient medical records progressively to assess hospital readmission, ED visits, and complications. Results: Of the 301 patients analyzed, 67.1% were female and 93% had class II obesity.The readmission rate, ED visit rate after discharge and the rate of either of the two was 8%, 14%,and 18.3%, respectively. The most common causes of readmission were abdominal pain (37.5%), nausea/vomiting (29.2%), and site leak (25%), while the most common causes of ED visits were abdominal pain (59.5%) and nausea/vomiting (16.9%). Readmission rates tended to be higher in older patients (age of patients readmitted 42 ± 12.1 years vs. age of patients not readmitted 34.3 ± 11.8 years; p = 0.002). The rate of readmission tends to increase in patients with overweight or class I obesity (odds ratio (OR) = 20.15), diabetes (OR = 14.82), and obstructive sleep apnea (OR = 14.29). Dyslipidemia was positively associated with ED visits (p = 0.027, OR = 2.87). The rate of readmission or ED visits increased with age, while there were decreases in readmission and ED visits for those who had received gastric sleeve surgery. Conclusions: The study reported high rates of readmission and ED visits, thus the effectiveness of different types of weight loss surgeries should be further evaluated, particularly in individuals with complicated medical issues such as diabetes, dyslipidemia, and obstructive sleep apnea.

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30-Day readmission after bariatric surgery in a publicly funded regionalized center of excellence system

Cited by 32 publications

References 29 publications

Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

Early and late complications of bariatric operation

Readmissions and Emergency Department Visits after Bariatric Surgery at Saudi Arabian Hospital: The Rates, Reasons, and Risk Factors

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