30-Day readmission rates at a high volume bariatric surgery center: Laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and vertical banded gastroplasty-Roux-en-Y gastric bypass

Abstract

This study found an overall 30-day readmission rate of 6.5% following bariatric operations at a high volume bariatric surgery program. This study supports the concept of bariatric surgery Centers of Excellence and accreditation of Bariatric Surgery Programs based on hospital volume of bariatric operations.

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

“…Comparison across studies with regard to readmission diagnoses is difficult considering the lack of standardized reporting. Despite this, nausea/vomiting, abdominal pain, and bleeding complications were among the most common diagnosis across all the studies which reported such outcomes [19][20][21][22][23] and is consistent with our study. From our multivariable analyses, we identified having a complication during index admission and a length of stay greater than 2 days as being significant predictors of readmission.…”

“…Previous 30-day readmission rates for bariatric surgery vary widely and have been reported from 0.5 to 11 % [14][15][16][17][18][19][20][21][22][23]. Variance between these studies is largely due to cohort size and type of procedure that is predominant with adjustable gastric banding having considerably lower readmission and complication rates than in RYGB [26,27].…”

“…Though none of the bariatric cohorts looked at complications during index procedure, three major cohorts of major abdominal surgery did and found that complications during index admission were associated with a 1.3-4 times higher risk of 30-day readmission [5][6][7]. Furthermore, four bariatric studies found that prolonged length of stay during index admission [18][19][20]23] was independently associated with readmission at 30 days. Within these studies, three of them defined a prolonged length of stay as greater than 3 days [19,20,23], while the other defined it as greater than 2 days [18].…”

“…Readmissions can triple the healthcare resource use after gastric bypass [15], and rates of 30-day readmission are as high as 11 % in RYGB cohorts [16][17][18][19][20][21][22][23]. This therefore gives healthcare systems an impetus and a short timeframe to intensively target and study in an effort to improve efficiency.…”

“…Readmission rates vary widely based on procedure type from 0.5 % after gastric banding to 11 % for Roux-en-Y gastric bypass (RYGB) [14][15][16][17][18][19][20][21][22][23]. Moreover, hospital use more than doubles after gastric bypass surgery [14], and readmissions after bariatric surgery can nearly triple riskadjusted health expenditure [15] in the first six months post-procedure.…”