Predictors of Hospital Readmission after Bariatric Surgery.
Publication/Presentation Date
7-1-2015
Abstract
BACKGROUND: Identification of factors that might predict readmission after bariatric surgery could help surgeons target high-risk patients. The purpose of this study was to identify comorbidities, surgical variables, and postoperative complications associated with readmission.
STUDY DESIGN: Patients with bariatric surgery as their primary procedure were identified from the 2012 American College of Surgeons (ACS) NSQIP database. Patient variables, operative times, and major postoperative complications were analyzed for predictors of readmission. The ACS NSQIP estimated probability of morbidity (MORBPROB) was also considered. Chi-square tests and Poisson regression were used for statistical analysis to identify significant predictors.
RESULTS: There were 18,186 patients who met inclusion criteria. There were 1,819 who had a laparoscopic gastric band, 9,613 who had laparoscopic Roux-en-Y gastric bypass (RYGB), 6,439 who had gastroplasties (vertical banded gastroplasty and sleeve), and 315 who had open RYGB. Age, sex, BMI, American Society of Anesthesiologists (ASA) class, diabetes, hypertension, steroid use, type of procedure, and operative time all were significantly associated with readmission within 30 days of operation. All major postoperative complications were significant predictors of readmission. Patients expected to be at high risk based on the ACS NSQIP MORBPROB had a significantly higher rate of readmissions. The overall readmission rate for patients undergoing bariatric surgery was 5%. The readmission rate among patients with any major complication was 31%.
CONCLUSIONS: Bariatric surgery is a low-risk procedure. Complexity of operation, ASA class, prolonged operative time, and major postoperative complications are important determinants of high risk for readmission. The ACS NSQIP MORBPROB may be a useful tool to identify and target patients at risk for readmission.
Volume
221
Issue
1
First Page
220
Last Page
227
ISSN
1879-1190
Published In/Presented At
Abraham, C. R., Werter, C. R., Ata, A., Hazimeh, Y. M., Shah, U. S., Bhakta, A., Tafen, M., Singh, P. T., Beyer, T. D., & Stain, S. C. (2015). Predictors of Hospital Readmission after Bariatric Surgery. Journal of the American College of Surgeons, 221(1), 220–227. https://doi.org/10.1016/j.jamcollsurg.2015.02.018
Disciplines
Medicine and Health Sciences
PubMedID
26047761
Department(s)
Department of Surgery
Document Type
Article