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Thirty-Day Readmission After Bariatric Surgery: Causes, Effects on Outcomes, and Predictors

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Abstract

Background

Bariatric surgery (BSx) is one of the most common surgical procedures in North America. Readmissions may be associated with a high burden to the healthcare system.

Methods

Retrospective study of the 2016 National Readmission Database of adult patients readmitted within 30 days after an index admission for BSx. Outcomes were: 30-day readmission rate, mortality, healthcare-related utilization resources, and independent predictors of readmission. Comparison groups were index admission, readmitted, and non-readmitted patients.

Results

A total of 161,141 patients underwent BSx. The 30-day readmission rate was 3.3%. Main causes for readmission were dehydration, acute kidney injury, venous thromboembolism events, and sepsis. Readmitted patients were more likely to develop shock (0.5% vs. 0.1%; P < 0.01) with no differences in mechanical ventilation (1.9% vs. 2.0%; P = 0.83) during index admission compared to non-readmitted patients. Readmission was associated with higher in-hospital mortality rate (1.5% vs. 0.1%; P < 0.01) and prolonged length of stay (4.6 vs. 2.4 days; P < 0.01). The total in-hospital economic burden of readmission was $234 million in total charges and $58.7 million in total costs. Independent predictors of readmission were: Charlson comorbidity index of ≥ 3, longer length of stay, admission to larger bed size hospitals, discharge to nursing home, and acute kidney injury. Medicaid, private insurance, BMI of 30–39 kg/m2, and 40–44 kg/m2 were associated with lower odds for readmission.

Conclusion

Readmissions after BSx are associated with higher in-hospital mortality rate and pose a high healthcare burden. We identified risk factors that can be targeted to decrease readmissions after BSx, healthcare burden, and patient morbidity and mortality.

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Authors and Affiliations

  1. Internal Medicine Department, John H. Stroger Hospital of Cook County, Rush University, Chicago, IL, USA

    Pedro Palacios Argueta

  2. Gastroenterology, Hepatology and Nutrition Department, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid avenue, Cleveland, OH, 44195, USA

    Miguel Salazar, John J. Vargo, Prabhleen Chahal, John J. Rodriguez & C. Roberto Simons-Linares

  3. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Christopher C. Thompson

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  1. Pedro Palacios Argueta
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  2. Miguel Salazar
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Correspondence to C. Roberto Simons-Linares.

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All authors declare that they have no conflict of interest.

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Because this study involved de-identified, publicly available data, it was exempt from institutional review board approval. Additionally, no patients were contacted during the study.

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Argueta, P.P., Salazar, M., Vargo, J.J. et al. Thirty-Day Readmission After Bariatric Surgery: Causes, Effects on Outcomes, and Predictors. Dig Dis Sci 67, 834–843 (2022). https://doi.org/10.1007/s10620-021-06934-2

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  • DOI: https://doi.org/10.1007/s10620-021-06934-2

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