Risk Factors for Readmission After Same-Day Discharge Sleeve Gastrectomy: a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database Analysis

• Published in: Obesity surgery Vol. 32; no. 4; pp. 962 - 969
• Main Authors: Dreifuss, Nicolas H., Xie, Julia, Schlottmann, Francisco, Cubisino, Antonio, Baz, Carolina, Vanetta, Carolina, Mangano, Alberto, Bianco, Francesco M., Gangemi, Antonio, Masrur, Mario A.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-04-2022; Springer Nature B.V
• Subjects: Accreditation; Adult; Bariatric Surgery - adverse effects; Bariatric Surgery - methods; Female; Gastrectomy - adverse effects; Gastrectomy - methods; Gastric Bypass - methods; Gastrointestinal surgery; Humans; Male; Medicine; Medicine & Public Health; Metabolism; Obesity, Morbid - surgery; Original Contributions; Patient Discharge; Patient Readmission; Quality Improvement; Retrospective Studies; Risk Factors; Surgery; Treatment Outcome; Laparoscopic sleeve gastrectomy; Outpatient bariatric surgery; Same-day discharge; Bariatric surgery; Ambulatory sleeve gastrectomy
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-022-05919-y

Background
Same-day discharge after sleeve gastrectomy (SG) is gaining popularity. We aimed to determine risk factors associated with readmission in patients who underwent same-day discharge SG.
Methods
We performed a retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database for the period 2015–2018. Patients who underwent SG and were discharged the same day of the operation were included in the analysis. Multivariable logistic regression analysis was performed to determine risk factors for readmission.
Results
A total of 466,270 SG were performed during the study period; 14,624 (3.1%) patients were discharged the same day and were included in the analysis. Mean age was 43.4 (14.7–80) years and 11,718 (80.1%) were female. Mean preoperative BMI was 43.7 ± 7.4 kg/m
2
. Mean operative time was 58.3 ± 32.4 min. Thirty-day reoperation, reintervention, and mortality rates were 0.7%, 0.7%, and 0.1%, respectively. Readmission rates were similar in same-day discharge and inpatient SG (2.9% vs. 3%,
p
 = 0.5). Female sex (OR 1.52, 95% CI 1.15–2.00), preoperative gastroesophageal reflux disease (OR 1.33, 95% CI 1.08–1.64), renal insufficiency (OR 3.06, 95% CI 1.01–9.32), and intraoperative drain placement (OR 1.78, 95% CI 1.37–2.31) were independent risk factors for readmission following same-day discharge SG.
Conclusions
Same-day discharge SG appears to be safe and is associated with low readmission rates. However, the identification of preoperative and intraoperative variables associated with higher risk of readmission might help defining safer and more effective same-day discharge protocols.
Graphical abstract