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Surgical Endoscopy

, Volume 30, Issue 5, pp 2066–2072 | Cite as

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

  • Aristithes G. DoumourasEmail author
  • Fady Saleh
  • Dennis Hong
Article

Abstract

Background

Avoidable readmission after surgery is a major burden on healthcare resources and is common after major surgery. Bariatric surgery is one of the most common surgical procedures in North America, and there is a paucity of strategies to prevent readmission. Strategies for prevention must first identify actual risk factors before interventions can be designed.

Methods

Our objective was to evaluate the readmission rate, characteristics of readmitted patients, and factors associated with readmission. We performed a population-based cohort study that included all patients who received a Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) procedure in Ontario from April 2009 until March 2012 for the purposes of weight loss. Data were derived from the Canadian Institute for Health Information Discharge Abstract Database and Hospital Morbidity Database.

Results

Over 3 years, 5007 procedures (91.7 % RYGB, 8.1 % SG) were performed with an overall 30-day readmission rate of 6.1 %. Readmission stays of 72 h or less accounted for 83 % of the cohort. The most common reasons for readmission were: infectious complications (24.6 %), pain (16.4 %) nausea/vomiting (11.5 %), bleeding complications (11.5 %), obstruction (5.6 %). A complication during initial admission OR 2.07 (95 % CI 1.44–2.97; P value < 0.001) and a length of stay greater than 2 days OR 1.40 (95 % CI 1.07–1.84; P value = 0.013) were independent predictors of readmission within 30 days.

Conclusion

The readmission rate after bariatric surgery in Ontario is similar to other major population-based bariatric surgery programs. Complications on initial admission and prolonged length of stay were independent predictors of readmission. Considering a large proportion of the readmissions were short term, future research into potential measures to prevent these readmissions is essential.

Keywords

Bariatric surgery Readmission Regionalized care 

Notes

Acknowledgments

This work was supported in part by funds from a Regional Medical Associates Grant (AG Doumouras and D Hong).

Compliance with ethical standards

Disclosures

Drs. Doumouras, Saleh, and Hong have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Aristithes G. Doumouras
    • 1
    • 2
    Email author
  • Fady Saleh
    • 2
  • Dennis Hong
    • 1
    • 2
  1. 1.Department of SurgeryMcMaster UniversityHamiltonCanada
  2. 2.Division of General SurgerySt. Joseph’s HealthcareHamiltonCanada

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