Predicting potentially preventable hospital readmissions following bariatric surgery

• Published in: Surgery for obesity and related diseases Vol. 11; no. 4; pp. 866 - 872
• Main Authors: Patterson, Wendy L., M.P.H, Peoples, Brittany D., M.S, Gesten, Foster C., M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2015
• Subjects: Adolescent; Adult; Bariatric surgery; Bariatric Surgery - adverse effects; Bariatric Surgery - methods; Body Mass Index; Co-morbidity; Female; Gastric bypass; Gastroenterology and Hepatology; Humans; Incidence; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Logistic regression; Male; Middle Aged; Obesity, Morbid - surgery; Patient Readmission - statistics & numerical data; Postoperative Complications - epidemiology; PPR; Preventable; Readmission; Retrospective Studies; Risk Assessment - methods; Risk Factors; Sleeve resection; Surgery; United States - epidemiology; Weight Loss; Young Adult; United States; Logistic regression; Sleeve resection; Preventable; PPR; Bariatric surgery; Gastric bypass; Laparoscopy; Readmission; Co-morbidity; Risk factors
• ISSN: 1550-7289; 1878-7533
• DOI: 10.1016/j.soard.2014.12.019

Abstract Background Using hospital readmissions as a quality of care measure predicates that some readmissions were preventable. Objectives: This study identifies predictors of potentially preventable readmissions (PPR) within 30 days of bariatric surgery discharge. Setting: New York State acute care hospitals. Methods Adult inpatient surgical discharges, during 2012, with a principal diagnosis of overweight or obesity and a principal procedure for bariatric surgery were identified. Logistic regression was used to evaluate surgical approach, sex, age, race/ethnicity, payor, body mass index, complications and co-morbidities recorded during the surgical admission. Results There were 10,448 surgeries studied for readmission of which 552 were followed by a PPR, for a statewide rate of 5.3 per 100 surgeries. Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) was the most common surgical approach (46.0%), then Sleeve Gastrectomy (SG) (41.3%), Laparoscopic Adjustable Gastric Band (LAGB) (8.1%), and Open Roux-en-Y Gastric Bypass (RYGB) (4.6%). RYGB had the highest PPR rate (8.8), followed by LRYGB (6.1), SG (4.3) and LAGB (3.3). Compared to LAGB, the odds of a PPR in patients with RYGB, LRYGB, and SG increased by 2.4 fold, 1.8 fold and 1.2 fold respectively. Black, non-Hispanic patients were at a greater risk of PPR (odds-ratio 2.0, P <.0001) compared to White, non-Hispanic patients while the risk of a PPR increased by 2-fold in patients with a surgical complication. Conclusions Taking all patient risk factors into account, the most significant predictors of a PPR were surgical approach, race and the presence of a surgical complication.