K. Feng1, J. S. Richman1, B. L. Corey1, R. D. Stahl1, J. M. Grams1 1University Of Alabama at Birmingham,Division Of Gastrointestinal Surgery/Department Of Surgery,Birmingham, Alabama, USA
Introduction: Laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the two most common bariatric operations. As both have low reported morbidity and mortality rates, readmission rates are increasingly utilized as a measure of quality. Identifying patients at risk will allow for targeted interventions to decrease readmissions. The purpose of this study was to evaluate national readmission rates and the associated risk factors related to RYGB and SG.
Methods: Data from patients undergoing SG or RYGB were identified from the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Chi-square test and logistic regression were used to examine patient characteristics and 30-day readmission rates. Patients were also stratified by bariatric procedure.
Results: A total of 144,459 patients were included RYGB (30.44%) and SG (69.56%). The overall 30-day readmission rate was 3.45% (n=4,991). SG patients had a lower readmission rate compared to RYGB (2.73% vs. 5.10%; p<0.001). The most common causes of readmission were nausea, vomiting, or dehydration (RYGB 26.83%, SG 32.32%); and abdominal pain (RYGB 14.55%, SG 11.71%). Unadjusted analyses showed that readmitted patients had higher body mass index (BMI), longer operation times, and more often had length of stay (LOS) >4 days (all p< 0.001). When stratified by operation, readmitted SG patients were more likely to have hypertension, hyperlipidemia, obstructive sleep apnea, and diabetes, while readmitted RYGB patients had longer operation time and more post-operative complications (all p< 0.001). Adjusted analyses (Table 1) showed that factors associated with readmission for both procedures included being African-American (SG OR=1.46, RYGB OR=1.24), LOS>4 (SG OR=3.63, RYGB OR=2.09), postoperative inpatient complications (SG OR=23.03, RYGB OR=9.21), all p<0.001.
Conclusion: Readmission after bariatric surgery was associated with race, BMI, diabetes, LOS, and inpatient postoperative complications. Further studies should focus on understanding these risk factors to reduce readmission rates.
