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Obesity Surgery

, Volume 26, Issue 7, pp 1371–1377 | Cite as

Trends in Bariatric Surgery: Procedure Selection, Revisional Surgeries, and Readmissions

  • Anasooya Abraham
  • Sayeed Ikramuddin
  • Cyrus Jahansouz
  • Fahd Arafat
  • Nathanael Hevelone
  • Daniel LeslieEmail author
Original Contributions

Abstract

Background

There are limited data quantifying national trends, post-operative readmissions, and revisional surgeries for bariatric procedures. We hypothesized that there is a trend away from Roux en Y gastric bypass (RYGB) and laparoscopic adjustable gastric bands (LAGB) in favor of vertical sleeve gastrectomies (VSG). We hypothesized that VSG was associated with fewer revisions and readmissions, and that demographics and comorbidities were associated with surgery received.

Methods

We used the US-based Premier database, 2008–2013 and 2014 first and second quarters to
  1. 1.

    Examine trends in incidence of RYGB, LAGB and VSG.

     
  2. 2.

    Quantify occurrence of revisional surgeries and readmissions.

     
  3. 3.

    Identify predictors of receipt of procedure and of readmissions.

     

Results

The proportion of VSG increased from 3.0 to 54 % from 2008 to 2014. RYGB decreased from 52 % in 2008 to 32 % by 2014. Earlier year, female sex, white race, western (versus southern) region, and Medicaid predicted receipt of RYGB. Later year, male sex, nonwhite race, northeast or western (versus southern) regions, and insurance type predicted VSG. Readmission was less likely for VSG (OR 0.72, 95 % CI 0.65–0.81), male sex (OR 0.83, 95 % CI 0.72–0.95), and more likely for black race (OR Black vs White 1.2, 95 % CI 1.1–1.4).

Conclusions

Discharge year strongly predicted surgery type. Females, whites, and Medicaid recipients received RYGB more than referents. Conversely, males, non-whites, and insured patients were more likely to receive VSG. Underinsured, regardless of surgery type, were more likely to be readmitted. These findings have important implications for health policy and cost-containment strategies.

Keywords

Bariatric surgery Vertical sleeve gastrectomy Roux en Y gastric bypass, laparoscopic adjustable gastric band Obesity 

Notes

Compliance with Ethical Standards

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Anasooya Abraham
    • 1
  • Sayeed Ikramuddin
    • 1
  • Cyrus Jahansouz
    • 1
  • Fahd Arafat
    • 1
  • Nathanael Hevelone
    • 2
  • Daniel Leslie
    • 1
    Email author
  1. 1.Department of SurgeryUniversity of MinnesotaMinneapolisUSA
  2. 2.Department of Healthcare OutcomesCovidien and MedtronicBostonUSA

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