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Rates and Predictors of 30-Day Readmissions in Patients Undergoing Bariatric Surgery in the US: a Nationwide Study

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Abstract

Background

Among various therapeutic options for morbid obesity, bariatric surgery (BS) is now considered one of the most effective methods of weight loss. We decided to perform an analysis to look at 30-day all-cause readmission and independent predictors of readmission in patients undergoing BS.

Methods

We queried the 2017 Nationwide Readmission Database (NRD) using ICD-10-CM diagnosis codes to identify all adult patients who underwent BS from January 1 to November 30, 2017. Outcomes assessed were 30-day readmission rates, mortality, length of stay (LOS) and hospitalization costs, and independent predictors of readmission.

Results

A total of 182,848 adult patients underwent BS during hospitalization in 2017, with in-hospital mortality rate of 0.52% (951). Of the patients discharged, 4.99% (9088) patients were readmitted within 30 days. The most common primary diagnosis at readmission was “Other complications of other bariatric surgery”. When compared with index admission, readmitted patients had higher in-hospital mortality (0.52% vs 2.06%, p < 0.01), increased mean LOS (2.94 days vs 5.94 days, p < 0.01) but lower mean hospitalization charges ($67,763 vs $66,065, p < 0.01). Increasing age (HR 1.01, 95% CI: 1.006–1.014, p < 0.01), longer LOS (HR 1.01, 95% CI: 1.008–1.014, p < 0.01), higher comorbidity score (HR 1.15, 95% CI: 1.12–1.18, p < 0.01), CHF (HR 1.19, 95% CI: 1.01–1.42, p < 0.05), and AKI (HR 1.64, 95% CI: 1.34–2.02, p < 0.01) were independently associated with increased likelihood of 30-day readmission.

Conclusion

This study shows that almost 5% patients undergoing bariatric surgery are readmitted within 30 days of discharge in the US. Further studies are needed to assess the high-risk populations to understand the reasons predisposing to early readmission.

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References

  1. Collaborators GBDO, Afshin A, Forouzanfar MH, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377(1):13–27.

    Article  Google Scholar 

  2. Roberto CA, Swinburn B, Hawkes C, et al. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. Lancet. 2015;385(9985):2400–9.

    Article  Google Scholar 

  3. Wang YC, McPherson K, Marsh T, et al. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378(9793):815–25.

    Article  Google Scholar 

  4. Emerging Risk Factors C, Wormser D, Kaptoge S, et al. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet. 2011;377(9771):1085–95.

    Article  Google Scholar 

  5. Singh GM, Danaei G, Farzadfar F, et al. The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis. PLoS One. 2013;8(7):e65174.

    Article  CAS  Google Scholar 

  6. Jain A. Treating obesity in individuals and populations. BMJ. 2005;331(7529):1387–90.

    Article  Google Scholar 

  7. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  Google Scholar 

  8. Steinbrook R. Surgery for severe obesity. N Engl J Med. 2004;350(11):1075–9.

    Article  CAS  Google Scholar 

  9. Sippey M, Kasten KR, Chapman WHH, et al. 30-day readmissions after sleeve gastrectomy versus Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2016;12(5):991–6.

    Article  Google Scholar 

  10. Encinosa WE, Bernard DM, Chen CC, et al. Healthcare utilization and outcomes after bariatric surgery. Med Care. 2006;44(8):706–12.

    Article  Google Scholar 

  11. Patterson WL, Peoples BD, Gesten FC. Predicting potentially preventable hospital readmissions following bariatric surgery. Surg Obes Relat Dis. 2015;11(4):866–72.

    Article  Google Scholar 

  12. Weller WE, Rosati C, Hannan EL. Relationship between surgeon and hospital volume and readmission after bariatric operation. J Am Coll Surg. 2007;204(3):383–91.

    Article  Google Scholar 

  13. Hong B, Stanley E, Reinhardt S, et al. Factors associated with readmission after laparoscopic gastric bypass surgery. Surg Obes Relat Dis. 2012;8(6):691–5.

    Article  Google Scholar 

  14. Dallal RM, Trang A. Analysis of perioperative outcomes, length of hospital stay, and readmission rate after gastric bypass. Surg Endosc. 2012;26(3):754–8.

    Article  Google Scholar 

  15. Kellogg TA, Swan T, Leslie DA, et al. Patterns of readmission and reoperation within 90 days after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2009;5(4):416–23.

    Article  Google Scholar 

  16. Major P, Wysocki M, Torbicz G, et al. Risk factors for prolonged length of hospital stay and readmissions after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2018;28(2):323–32.

    Article  Google Scholar 

  17. Abraham CR, Werter CR, Ata A, et al. Predictors of hospital readmission after bariatric surgery. J Am Coll Surg. 2015;221(1):220–7.

    Article  Google Scholar 

  18. Lois AW, Frelich MJ, Sahr NA, et al. The relationship between duration of stay and readmissions in patients undergoing bariatric surgery. Surgery. 2015;158(2):501–7.

    Article  Google Scholar 

  19. Dang JT, Tavakoli I, Switzer N, et al. Factors that predict 30-day readmission after bariatric surgery: experience of a publicly funded Canadian Centre. Can J Surg. 2020;63(2):E174–E80.

    Article  Google Scholar 

  20. Lazzati A, Chatellier G, Katsahian S. Readmissions after bariatric surgery in France, 2013-2016: a nationwide study on administrative data. Obes Surg. 2019;29(11):3680–9.

    Article  Google Scholar 

  21. Kansagara D, Englander H, Salanitro A, et al. Risk prediction models for hospital readmission: a systematic review. JAMA. 2011;306(15):1688–98.

    Article  CAS  Google Scholar 

  22. Agency for Healthcare Research and Quality. Introduction the HCUP Nationwide Readmissions Database (NRD). [3/29/2020]; Available from: https://www.hcup-us.ahrq.gov/nrdoverview.jsp.

  23. Abougergi MS, Peluso H, Saltzman JR. Thirty-day readmission among patients with non-variceal upper gastrointestinal hemorrhage and effects on outcomes. Gastroenterology. 2018;155(1):38–46. e1

    Article  Google Scholar 

  24. Young MT, Gebhart A, Phelan MJ, et al. Use and outcomes of laparoscopic sleeve gastrectomy vs laparoscopic gastric bypass: analysis of the American College of Surgeons NSQIP. J Am Coll Surg. 2015;220(5):880–5.

    Article  Google Scholar 

  25. Zingmond DS, McGory ML, Ko CY. Hospitalization before and after gastric bypass surgery. JAMA. 2005;294(15):1918–24.

    Article  CAS  Google Scholar 

  26. Cardoso L, Rodrigues D, Gomes L, et al. Short- and long-term mortality after bariatric surgery: a systematic review and meta-analysis. Diabetes Obes Metab. 2017;19(9):1223–32.

    Article  Google Scholar 

  27. Pope GD, Birkmeyer JD, Finlayson SR. National trends in utilization and in-hospital outcomes of bariatric surgery. J Gastrointest Surg. 2002;6(6):855–60. discussion 61

    Article  Google Scholar 

  28. Dorman RB, Miller CJ, Leslie DB, et al. Risk for hospital readmission following bariatric surgery. PLoS One. 2012;7(3):e32506.

    Article  CAS  Google Scholar 

  29. Willson TD, Gomberawalla A, Mahoney K, et al. Factors influencing 30-day emergency visits and readmissions after sleeve gastrectomy: results from a community bariatric center. Obes Surg. 2015;25(6):975–81.

    Article  Google Scholar 

  30. Tayne S, Merrill CA, Shah SN, et al. Risk factors for 30-day readmissions and modifying postoperative care after gastric bypass surgery. J Am Coll Surg. 2014;219(3):489–95.

    Article  Google Scholar 

  31. Baker MT, Lara MD, Larson CJ, et al. Length of stay and impact on readmission rates after laparoscopic gastric bypass. Surg Obes Relat Dis. 2006;2(4):435–9.

    Article  Google Scholar 

  32. Huerta S, Heber D, Sawicki MP, et al. Reduced length of stay by implementation of a clinical pathway for bariatric surgery in an academic health care center. Am Surg. 2001;67(12):1128–35.

    CAS  PubMed  Google Scholar 

  33. Kelly KN, Iannuzzi JC, Rickles AS, et al. Risk factors associated with 30-day postoperative readmissions in major gastrointestinal resections. J Gastrointest Surg. 2014;18(1):35–43. discussion −4

    Article  Google Scholar 

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Correspondence to Sachit Sharma.

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Sharma, S., Aziz, M., Vohra, I. et al. Rates and Predictors of 30-Day Readmissions in Patients Undergoing Bariatric Surgery in the US: a Nationwide Study. OBES SURG 31, 62–69 (2021). https://doi.org/10.1007/s11695-020-04884-8

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  • DOI: https://doi.org/10.1007/s11695-020-04884-8

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