Risk Factors Associated with Prolonged Hospital Stay and Readmission in Patients After Primary Bariatric Surgery.

ABSTRACT

INTRODUCTION: The introduction of enhanced recovery after surgery (ERAS) has resulted in a decrease in length of hospital stay of patients after bariatric surgery. The general length of hospital stay is 1 day. Some bariatric patients stay longer after an uncomplicated procedure or are readmitted for varying reasons. OBJECTIVES: The aim of the present study is to identify risk factors associated with prolonged hospital stay and readmissions. METHODS: A retrospective study of all patients who underwent a primary procedure (i.e. Roux-en-Y gastric bypass or sleeve gastrectomy) between January 2016 and January 2019 was performed. RESULTS: A total of 1669 patients who underwent primary laparoscopic Roux-en-Y gastric bypass (70.7%) or sleeve gastrectomy (29.3%) were included. The median length of stay was 1 day (range 1-69 days). In 138 patients (8.3%), a postoperative complication was diagnosed and 89 patients were readmitted (5.3%) within 30 days after discharge. Overall, 348 patients (20.9%) stayed longer than 1 day. Univariable analysis showed that depression, ASA III, sleeve gastrectomy and a perioperative and/or postoperative complication were significantly (p value < 0.05) associated with a prolonged stay. In the multivariable model depression, sleeve gastrectomy and postoperative complication were independent risk factors for prolonged stay. Univariable analysis of risk factors associated with readmission identified depression and perioperative and postoperative complications. Multivariable analysis for readmission demonstrated only presence of a postoperative complication was an independent risk factor. CONCLUSION: Depression, sleeve gastrectomy and postoperative complications were independent risk factors for prolonged stay. Postoperative complication was an independent risk factor for readmission.