NEW YORK (Reuters Health) – About one in 20 bariatric surgery patients are readmitted to the hospital within 30 days of having the procedure, according to new findings.
Readmissions are increasingly being used as a quality metric for surgical procedures, Dr. John Morton of Stanford University in California and colleagues note in their report, published online March 19 in the American Journal of Surgery.
“While (the Centers for Medicare and Medicaid Services) has not addressed bariatric surgery readmissions to date, other payors have made readmissions a priority,” they add. “Data regarding bariatric surgery readmissions are critical to help better understand and drive quality improvement in this area.
“To investigate the prevalence, causes and risk factors for readmission following bariatric surgery, the researchers looked at data from the 2012 American College of Surgeons National Surgical Quality Improvement Program Public Use File dataset on nearly 18,300 bariatric patients, of whom 55% had laparoscopic Roux-en-Y gastric bypass (LRYGB), 10% had laparoscopic adjustable gastric banding (LAGB), and 35% had laparoscopic sleeve gastrectomy (LSG).
There were 955 readmissions (5.22%), most commonly for gastrointestinal causes (45%), dietary reasons (34%) and bleeding (7%). Readmission rates were nearly 7% for LRYGB; just under 2% for LAGB; and 4% for LSG.
The patients who were readmitted had a significantly longer average operating time (132 vs. 115 minutes) and length of stay (2.76 days vs. 2.23). Forty percent had a complication, versus 4% of patients who were not readmitted. Patients who were readmitted were also more likely to have a body mass index above 50, preoperative diabetes, chronic obstructive pulmonary disease, and hypertension.
Factors independently associated with readmission included African-American race (odds ratio, 1.53), complication (OR, 11.3) and resident involvement (OR, 0.53).
“Other studies have also demonstrated similar predictors of readmission and have also demonstrated that length of stay may also play a role in readmission rates,” Dr. Morton and his team state. “This study helps demonstrate that bariatric surgery readmissions are prevalent and potentially preventable.”