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

• Published in: Digestive diseases and sciences Vol. 67; no. 3; pp. 834 - 843
• Main Authors: Argueta, Pedro Palacios, Salazar, Miguel, Vargo, John J., Chahal, Prabhleen, Rodriguez, John J., Simons-Linares, C. Roberto, Thompson, Christopher C.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2022; Springer; Springer Nature B.V
• Subjects: Acute Kidney Injury - epidemiology; Acute Kidney Injury - etiology; Acute Kidney Injury - therapy; Adult; Analysis; Bariatric Surgery - adverse effects; Biochemistry; Comorbidity; Databases, Factual; Disease susceptibility; Female; Gastroenterology; Gastrointestinal surgery; Health aspects; Hepatology; Hospitals; Humans; Kidneys; Length of stay; Male; Medicaid; Medicine; Medicine & Public Health; Mortality; Obesity; Oncology; Original Article; Patient Readmission; Retrospective Studies; Risk Factors; Surgery; Time Factors; Transplant Surgery; United States - epidemiology; United States; Readmission; Outcomes; Bariatric surgery
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-021-06934-2

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/m 2 , and 40–44 kg/m 2 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.