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

Abstract

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.

The influences of bariatric surgery on hemoglobin A1c in a sample of obese patients in Saudi Arabia

“…Recently, Ahmed et al, in a study conducted at King Abdulaziz Medical City in Riyadh, reported a hospital readmission rate of 8% and an emergency department visit rate of 14% in obese Saudi patients who underwent bariatric surgery. 25 According to this study, LSG was associated with fewer hospital readmissions or emergency department visits as compared to RYGB.…”

Seventy-two-hour emergency department revisits among adults with chronic diseases: a Saudi Arabian study

“…The ED revisit within 72 hours has been widely reported in earlier studies, and its rate depends on the chronic disease status and the cultural background. 6 – 12 The rates of 72-hour ED revisits may depend on age, 10 , 11 gender, 10 , 13 disease categories, 6 – 8 , 12 medical errors, 7 , 8 patients, 7 and doctors. 7 Although data regarding ED revisits within 72 hours can be used to implement changes and modifications to improve the electronic medical record database, the rate of revisits to the ED within 72 hours has not been documented among adults with chronic diseases in Saudi Arabia, particularly in our center.…”

Mindset and Communication Barriers in the Diffusion of Bariatric Surgery

“…[15], medical (nutritional deficiencies, kidney stones, bone fragility, hyperinsulinemic hypoglycemia, etc) [16] and psychiatric (self-harm, substance abuse) [17]. The likelihood of consultations to emergency departments and accumulation of diagnostic irradiation by computer tomography might be also elevated after BS [18]. RYGB has the additional sequel of making the choledochus inaccessible orally, complicating the eventual future treatment of bile duct lithiasis, which is why some surgeons advocate concomitant prophylactic cholecystectomy [19].…”