Hospitalization Before and After Gastric Bypass Surgery

Abstract

Context The use of Roux-en-Y gastric bypass (RYGB) has been reported to be effective in the treatment of obesity and its related comorbidities. Utilization of inpatient services after RYGB is less well understood. Objective To determine the rates and indications for inpatient hospital use before and after RYGB. Design, Setting, and Participants Retrospective study of Californians receiving RYGB in California hospitals from 1995 to 2004. Main Outcome Measure Hospitalization in the 1 to 3 years after RYGB. Results In California from 1995 to 2004, 60 077 patients underwent RYGB-11 659 in 2004 alone. The rate of hospitalization in the year following RYGB was more than double the rate in the year preceding RYGB (19.3% vs 7.9%, PϽ.001). Furthermore, in the subset of patients (n = 24 678) with full 3-year follow-up, a mean of 8.4% were admitted a year before RYGB while 20.2% were readmitted in the year after RYGB, 18.4% in the second year after RYGB, and 14.9% in the third year after RYGB. The most common reasons for admission prior to RYGB were obesity-related problems (eg, osteoarthritis, lower extremity cellulitis), and elective operation (eg, hysterectomy), while the most common reasons for admission after RYGB were complications often thought to be procedure related, such as ventral hernia repair and gastric revision. In multivariate logistic regression models predicting 1-year readmission after RYGB, increasing Charlson Comorbidity Index score, and hospitalization in the 3-year period prior to RYGB were significantly associated with readmission within a year. Conclusions Increases in hospital use after surgery appear to be related to RYGB. Payers, clinicians, and patients must consider the not-inconsequential rate of rehospitalization after this type of surgery.

Costs and usage of healthcare services before and after open bariatric surgery

“…The same occurred in the three-year follow-up cohort of Zingmond et al 21 and the studies by Encinosa et al 22 Our findings confirm that, at least over the short term, from the payer's point of view, the costs do not diminish after surgery; instead, they tend to increase. As expected, the costs in the subgroup with any type of complication after bariatric surgery or a gastrointestinal tract procedure were much higher than among those with uncomplicated procedures.…”

Surgical treatment of obesity

“…Mortality after 30 days varies between 0.1 and 4.6% (29,58). For all 60.077 patients who underwent Roux-en-Y gastric bypass in California in the period 1995-2004, the overall in-hospital mortality rate was 0.18%, 30-day mortality was 0.33%, and 1-year mortality was 0.91% (59). These results are similar to those found in a recent audit of 1144 cases from 29 academic centers in the United States in which the 30-day mortality rate for gastric bypass was 0.4% (60).…”

Medication and nutrient administration considerations after bariatric surgery

“…2006; 63:1852-7 than in the year preceding it. 5 Given the increase in bariatric surgeries performed, many health professionals have become involved in the postoperative care of these patients. Concerns related to medication administration in the obese population and nutrient intake in patients who for the terms gastric bypass, bariatric surgery, weight-loss surgery, medications, and absorption was conducted.…”