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Outcomes of same-day discharge in bariatric surgery

Sydney Cooper1, Shivam Patel1, Matthew Wynn1

  • 1Department of Bariatric Surgery, Baylor Scott & White Hospital - Temple, Baylor College of Medicine, 2401 S 31St St MS-01-712, Temple, TX, 76508, USA.

Surgical Endoscopy
|July 19, 2024
PubMed

Insights

Same-day discharge after bariatric surgery is safe for select patients. While most outcomes were similar, some inpatient groups had higher readmission and ER visit rates.

Area of Science:

  • Bariatric Surgery Outcomes
  • Surgical Patient Discharge Protocols
  • Minimally Invasive Surgery

Background:

  • The COVID-19 pandemic prompted a shift towards same-day discharge in bariatric surgery.
  • Existing research on the safety and efficacy of this approach yields conflicting results.
  • This study aims to compare patient outcomes following same-day discharge versus traditional inpatient admission after bariatric procedures.

Purpose of the Study:

  • To compare the safety and efficacy of same-day discharge versus inpatient admission after bariatric surgery.
  • To analyze key outcomes including emergency room visits, reoperations, IV fluid treatments, readmissions, and mortality.
  • To evaluate secondary outcomes such as infection, pulmonary embolism, and acute kidney injury.

Main Methods:

  • A retrospective analysis of 1225 patients undergoing laparoscopic or robotic-assisted sleeve gastrectomy or Roux-En-Y gastric bypass.
  • Patients were categorized into outpatient (same-day discharge) and inpatient (postoperative day one discharge) groups.
  • Outcomes were compared using statistical analysis, focusing on 30-day morbidity and mortality.

Main Results:

  • Outpatient groups generally had lower BMI and fewer comorbidities compared to inpatient groups.
  • No significant differences were observed in reoperations, IV fluid treatments, or 30-day mortality between inpatient and outpatient groups for either surgery type.
  • The inpatient sleeve gastrectomy group had higher readmission rates (4.6% vs 2.1%), and the inpatient gastric bypass group had more ER visits (21.7% vs 10%) compared to their respective outpatient counterparts.

Conclusions:

  • Same-day discharge is a safe and viable option for bariatric surgery patients, particularly those with minimal comorbidities.
  • Careful patient selection is crucial for successful same-day discharge protocols.
  • Further research may refine criteria for identifying suitable candidates for outpatient bariatric procedures.
Abstract

Keywords:
Bariatric surgery complicationsRobotic bariatric surgeryRoux-en-Y gastric bypassSame-day bariatric surgerySleeve gastrectomy

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