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Characterizing Readmissions After Bariatric Surgery

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Readmissions are an important quality metric for surgery. Here, we compare characteristics of readmissions across laparoscopic Roux­en-Y gastric bypass (LRYGB), sleeve gastrectomy (LSG), and adjustable gastric band (LAGB).

Methods

Demographic, intraoperative, anthropometric, and laboratory data were prospectively obtained for 1775 patients at a single academic institution. All instances of readmissions within 1 year were recorded. Data were analyzed using STATA, release 12.

Results

For the 1775 patients, 113 (6.37 %) were readmitted. Mean time to readmission was 52.1 days. Of all the readmissions, 64.6 % were within 30 days, 22.1 % from 30 to 90 days, 1.77 % from 90 to 180 days, and 11.5 % from 180 to 365 days. Incidence of 30-day readmissions varied across surgeries (LRYGB: 7.17 %; LAGB: 3.05 %; LSG: 4.25 %, p = 0.04). Time to readmission varied as well, with 90.0 % of LSG and 80.0 % of LABG patients within the first 30 days, versus 60.8 % of LRYGB (p = 0.02). The most common causes of readmissions were gastrointestinal issues related to index procedure (34.5 %) and did not vary across surgeries. In multivariable logistic regression, index hospital length of stay (LOS) was associated with readmission (OR = 1.07, 95 % CI 1.02–1.13, p = 0.01).

Conclusions

Readmissions after bariatric surgery are associated with high index hospital LOS, and a measureable proportion of procedure-related readmissions can occur up to 1 year, especially for LRYGB.

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Acknowledgements

We would like to thank the multi-disciplinary team of medical students, physicians, nurses, and dieticians at the Stanford Bariatric and Metabolic Interdisciplinary clinic for their support throughout this clinical investigation.

Authors’ Contributions

TG, UR, DR, HH, HR, JMM. Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: ALL

Drafting the work or revising it critically for important intellectual content: ALL

Final approval of the version to be published: ALL

Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: ALL

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Authors and Affiliations

  1. Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, Stanford, USA

    Trit Garg, Ulysses Rosas, Daniel Rogan, Harrison Hines, Homero Rivas, John M. Morton & Dan Azagury

  2. 300 Pasteur Drive, H3680, Stanford, CA, 94305, USA

    John M. Morton

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  1. Trit Garg
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  2. Ulysses Rosas
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  4. Harrison Hines
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  7. Dan Azagury
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Correspondence to John M. Morton.

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Garg, T., Rosas, U., Rogan, D. et al. Characterizing Readmissions After Bariatric Surgery. J Gastrointest Surg 20, 1797–1801 (2016). https://doi.org/10.1007/s11605-016-3247-3

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  • DOI: https://doi.org/10.1007/s11605-016-3247-3

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