Predictors of Readmission After Laparoscopic Gastric Bypass and Sleeve Gastrectomy: a Comparative Analysis of ACS-NSQIP Database

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2015 Aug 27

PMID 26307598

Citations 28

Authors

Zhamak Khorgami

Amin Andalib

Ali Aminian

Matthew D Kroh

Philip R Schauer

Stacy A Brethauer

Affiliations

Soon will be listed here.

Abstract

Background: Readmission rate is an indicator of quality in surgical practice. We aimed to determine the predictors of unplanned early readmissions following stapling bariatric surgeries.

Methods: From the American College of Surgeons National Surgical Quality Improvement Program database, we identified morbidly obese patients, who underwent either laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) in 2012 and 2013. Demographic, comorbidities, operative and postoperative parameters of the readmitted (within 30 days) and non-readmitted patients were evaluated using a multivariate logistic regression analysis.

Results: A total of 35,655 patients (17,101 LSG and 18,554 LRYGB) were analyzed. Of those, 1758 patients (4.9 %) were readmitted within 30 days of surgery. Multivariate analysis showed the following significant predictors for readmission: Non-Hispanic black ethnicity (OR: 1.56, 95 % CI:1.34-1.81), Hispanic ethnicity (OR: 1.29, 95 % CI:1.05-1.58), totally or partially dependent functional status (OR: 1.94, 95 % CI:1.06-3.55), higher preoperative creatinine (OR: 1.13, 95 % CI:1.04-1.22), lower serum albumin (OR: 0.78, 95 % CI:0.68-0.90), diabetes mellitus on insulin (OR: 1.28, 95 % CI:1.09-1.51), steroid or immunosuppressant use for a chronic condition (OR: 1.61, 95 % CI:1.11-2.33), history of cardiac disease with intervention (OR: 2.05, 95 % CI:1.10-3.83), bleeding disorders (OR: 1.71, 95 % CI:1.15-2.54), LRYGB versus LSG (OR: 1.63, 95 % CI:1.44-1.85), longer operative time (OR: 1.13, 95 % CI:1.07-1.20), concurrent splenectomy (OR: 4.10, 95 % CI:1.05-16.01), and occurrence of any postoperative complication during index admission (OR: 2.61, 95 % CI:1.99-3.42).

Conclusions: Ethnicity, baseline functional status, comorbidities, type and duration of surgical procedure, and postoperative complications occurred in the index admission can predict risk of early readmission following LRYGB and LSG.

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References

Schauer P, Bhatt D, Kirwan J, Wolski K, Brethauer S, Navaneethan S . Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N Engl J Med. 2014; 370(21):2002-13. PMC: 5451259. DOI: 10.1056/NEJMoa1401329. View

Dorman R, Miller C, Leslie D, Serrot F, Slusarek B, Buchwald H . Risk for hospital readmission following bariatric surgery. PLoS One. 2012; 7(3):e32506. PMC: 3296721. DOI: 10.1371/journal.pone.0032506. View

Encinosa W, Bernard D, Chen C, Steiner C . Healthcare utilization and outcomes after bariatric surgery. Med Care. 2006; 44(8):706-12. DOI: 10.1097/01.mlr.0000220833.89050.ed. View

Hansen L, Young R, Hinami K, Leung A, Williams M . Interventions to reduce 30-day rehospitalization: a systematic review. Ann Intern Med. 2011; 155(8):520-8. DOI: 10.7326/0003-4819-155-8-201110180-00008. View

Shelkrot M, Miraka J, Perez M . Appropriate enoxaparin dose for venous thromboembolism prophylaxis in patients with extreme obesity. Hosp Pharm. 2014; 49(8):740-7. PMC: 4252202. DOI: 10.1310/hpj4908-740. View

Hong B, Stanley E, Reinhardt S, Panther K, Garren M, Gould J . Factors associated with readmission after laparoscopic gastric bypass surgery. Surg Obes Relat Dis. 2011; 8(6):691-5. DOI: 10.1016/j.soard.2011.05.019. View

Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri S . Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg. 1999; 134(1):36-42. DOI: 10.1001/archsurg.134.1.36. View

Sacks G, Dawes A, Russell M, Lin A, Maggard-Gibbons M, Winograd D . Evaluation of hospital readmissions in surgical patients: do administrative data tell the real story?. JAMA Surg. 2014; 149(8):759-64. DOI: 10.1001/jamasurg.2014.18. View

Lawson E, Hall B, Louie R, Zingmond D, Ko C . Identification of modifiable factors for reducing readmission after colectomy: a national analysis. Surgery. 2014; 155(5):754-66. DOI: 10.1016/j.surg.2013.12.016. View

10.

Brethauer S, Aminian A, Romero-Talamas H, Batayyah E, Mackey J, Kennedy L . Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013; 258(4):628-36. PMC: 4110959. DOI: 10.1097/SLA.0b013e3182a5034b. View

11.

Saunders J, Ballantyne G, Belsley S, Stephens D, Trivedi A, Ewing D . 30-day readmission rates at a high volume bariatric surgery center: laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and vertical banded gastroplasty-Roux-en-Y gastric bypass. Obes Surg. 2007; 17(9):1171-7. DOI: 10.1007/s11695-007-9210-3. View

12.

Aminian A, Mirsharifi R, Karimian F, Khorgami Z, Nasiri S, Yazdankhah-Konari A . Influence of splenectomy on morbidity of esophageal cancer surgery. Scand J Surg. 2010; 99(1):9-13. DOI: 10.1177/145749691009900103. View

13.

Abraham C, Werter C, Ata A, Hazimeh Y, Shah U, Bhakta A . Predictors of Hospital Readmission after Bariatric Surgery. J Am Coll Surg. 2015; 221(1):220-7. DOI: 10.1016/j.jamcollsurg.2015.02.018. View

14.

Kariv Y, Wang W, Senagore A, Hammel J, Fazio V, Delaney C . Multivariable analysis of factors associated with hospital readmission after intestinal surgery. Am J Surg. 2006; 191(3):364-71. DOI: 10.1016/j.amjsurg.2005.10.038. View

15.

Fonarow G, Stevenson L, Walden J, Livingston N, Steimle A, Hamilton M . Impact of a comprehensive heart failure management program on hospital readmission and functional status of patients with advanced heart failure. J Am Coll Cardiol. 1997; 30(3):725-32. DOI: 10.1016/s0735-1097(97)00208-8. View

16.

Akutsu Y, Matsubara H . Perioperative management for the prevention of postoperative pneumonia with esophageal surgery. Ann Thorac Cardiovasc Surg. 2009; 15(5):280-5. View

17.

Gupta P, Ramanan B, Lynch T, Sundaram A, MacTaggart J, Gupta H . Development and validation of a risk calculator for prediction of mortality after infrainguinal bypass surgery. J Vasc Surg. 2012; 56(2):372-9. PMC: 3613335. DOI: 10.1016/j.jvs.2012.01.042. View

18.

Khorgami Z, Arheart K, Zhang C, Messiah S, de la Cruz-Munoz N . Effect of ethnicity on weight loss after bariatric surgery. Obes Surg. 2014; 25(5):769-76. DOI: 10.1007/s11695-014-1474-9. View

19.

Aminian A, Daigle C, Romero-Talamas H, Kashyap S, Kirwan J, Brethauer S . Risk prediction of complications of metabolic syndrome before and 6 years after gastric bypass. Surg Obes Relat Dis. 2014; 10(4):576-82. DOI: 10.1016/j.soard.2014.01.025. View

20.

Buchwald H, Avidor Y, Braunwald E, Jensen M, Pories W, Fahrbach K . Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004; 292(14):1724-37. DOI: 10.1001/jama.292.14.1724. View