Same-Day Discharge after Metabolic Bariatric Surgery: Methodological Heterogeneity, Discharge Success Rates and...

Area of Science:

• Bariatric Surgery
• Surgical Outcomes
• Evidence Synthesis

Background:

• Same-day discharge after metabolic bariatric surgery (MBS) is a growing trend.
• The validity of pooling existing evidence on same-day discharge MBS is unknown due to potential heterogeneity.
• This review assesses the standardization of criteria in same-day discharge studies to determine if meta-analysis is feasible.

Purpose of the Study:

• To systematically review studies on same-day discharge after MBS.
• To assess the standardization of patient selection and discharge criteria.
• To evaluate the feasibility of evidence synthesis through meta-analysis.

Main Methods:

• Searched CENTRAL, PubMed, and EMBASE for same-day discharge MBS studies.
• Extracted and analyzed inclusion, exclusion, and discharge criteria verbatim.
• Performed thematic content analysis to identify commonalities and variations in criteria definitions.

Main Results:

• 95-100% of studies used unique criteria definitions, hindering meta-analysis.
• Significant heterogeneity in criteria thresholds (e.g., age, BMI, ASA score) was observed across studies.
• Success rates varied (63-100%), but safety outcomes (readmission, mortality, leaks) could not be pooled due to inconsistent definitions.

Conclusions:

• Severe methodological heterogeneity prevents valid meta-analysis of same-day discharge MBS research.
• Stratified analysis suggests a potential higher mortality risk for same-day discharge after RYGB compared to sleeve gastrectomy.
• International consensus on standardized, procedure-specific criteria is urgently needed for future research.