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Am J Surg. 2016 Jul;212(1):76-80. doi: 10.1016/j.amjsurg.2016.01.023. Epub 2016 Mar 19.

National prevalence, causes, and risk factors for bariatric surgery readmissions.

Author information

1
Department of Surgery, Section of Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA.
2
Department of Surgery, Section of Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA. Electronic address: morton@stanford.edu.

Abstract

BACKGROUND:

Readmissions are often used as a quality metric particularly in bariatric surgery.

METHODS:

Laparoscopic Roux en Y gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy were identified using Current Procedure Terminology codes in the 2012 National Surgical Quality Improvement Program public use file.

RESULTS:

A total of 18,296 patients were included, 10,080 (55.1%) were laparoscopic Roux en Y gastric bypass, 1,829 (10.0%) were laparoscopic adjustable gastric banding, and 6,387 (34.9%) were laparoscopic sleeve gastrectomy. Among all patients, 955 (5.22%) were readmitted. Patients with readmissions had a higher proportion of body mass index greater than 50 (30.2% vs 24.6%, P < .001), higher index operative time (132 minutes vs 115, P < .001) and greater proportion with length of stay greater than 4 days (9.57% vs 3.36%, P < .001). Readmitted patients were more likely to have diabetes (31.1% vs 27.7%, P = .02), chronic obstructive pulmonary disease (2.63% vs 1.72%, P = .04), and hypertension (54.5% vs 50.8%, P = .03). Overall, 40.6% of readmitted patients had a complication. Common readmissions were gastrointestinal-related (45.0%), dietary (33.5%), and bleeding (6.57%). Readmission was independently associated with African-American race (odds ratio [OR] = 1.53, P = .02), complication (OR = 11.3, 95%, P < .001), and resident involvement (OR = .53, P = .04).

CONCLUSIONS:

A 30-day readmission after bariatric surgery is prevalent and closely associated with complications.

KEYWORDS:

Bariatric surgery; Obesity; Readmissions

PMID:
27133197
DOI:
10.1016/j.amjsurg.2016.01.023
[Indexed for MEDLINE]

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