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The relationship between duration of stay and readmissions in patients undergoing bariatric surgery
Alex W Lois1, Matthew J Frelich1, Natasha A Sahr2
1Division of General Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Insights
Shorter hospital stays after bariatric surgery do not increase readmission risks. Longer hospitalizations are linked to higher readmission rates, suggesting early discharge is safe for bariatric surgery patients.
Area of Science:
- Bariatric Surgery Outcomes
- Health Services Research
- Quality Improvement in Healthcare
Background:
- Hospital readmissions are a key quality metric in bariatric surgery.
- Recent trends show a significant decrease in postoperative hospital stay duration.
- Investigating the impact of reduced hospital stay on readmission rates is crucial.
Purpose of the Study:
- To test the hypothesis that shorter postoperative hospitalization does not increase readmission likelihood after bariatric surgery.
- To analyze the relationship between length of stay and 30-day readmission rates.
- To inform clinical practice regarding discharge timing post-bariatric procedures.
Main Methods:
- Multicenter analysis using The University HealthSystem Consortium (UHC) clinical database (January 2009–December 2013).
- Inclusion of patients aged 18+ undergoing bariatric procedures, identified via ICD-9 codes.
- Analysis of inpatient stay data and 30-day readmissions for 95,294 patients.
Main Results:
- A total of 95,294 patients were analyzed, with 5.7% readmitted within 30 days.
- Patients hospitalized for 3 days or more were significantly more likely to be readmitted.
- Readmission likelihood increased twofold for 3-day stays and fourfold for longer stays compared to 1-day stays (P < .001).
Conclusions:
- Longer postoperative hospitalizations are associated with increased readmission rates following bariatric surgery.
- Early discharge appears to be safe and not linked to higher readmission rates.
- Findings support current trends toward shorter hospital stays in bariatric surgery care.
Background:
Hospital readmissions are a quality indicator in bariatric surgery. In recent years, duration of stay after bariatric surgery has trended down greatly. We hypothesized that a shorter postoperative hospitalization does not increase the likelihood of readmission.
Methods:
The University HealthSystem Consortium (UHC) is an alliance of academic medical centers and affiliated hospitals. The UHC's clinical database contains information on inpatient stay and returns (readmissions) up to 30 days after discharge. A multicenter analysis of outcomes was performed by the use of data from the January 2009 to December 2013 for patients 18 years and older. Patients were identified by bariatric procedure International Classification of Diseases, Ninth Revision, codes and restricted by diagnosis codes for morbid obesity.
Results:
A total of 95,294 patients met inclusion criteria. The mean patient age was 45.4 (±0.11) years, and 73,941 (77.6%) subjects were female. There were 5,423 (5.7%) readmissions within the study period. Patients with hospitalizations of 3 days and more than 3 days were twice and four times as likely to be readmitted than those with hospitalizations of one day, respectively (P < .001).
Conclusion:
Patients with longer postoperative hospitalizations were more likely to be readmitted after bariatric surgery. Early discharge does not appear to be associated with increased readmission rates.
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