Background

Readmission after bariatric surgery is associated with less cost-effectiveness and is a preventable quality metric with standardized practices. Reasons for readmission among racial/ethnic bariatric cohorts is less explored and understood. Objective: Our study objective was to determine reasons for readmission among racial/ethnic cohorts of bariatric patients. Setting: Academic Hospital.

Methods

We performed a retrospective analysis of the 2015 to 2018 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Project (MBSAQIP) databases to identify Roux-en-Y Gastric Bypass (RYGB) and sleeve gastrectomy (SG) cases. Predictors of all-cause and bariatric-related readmission were determined by regression analyses. Reasons for readmission were compared between racial/ethnic cohorts. Variables were assessed by Pearson chi-square and Kruskal-Wallis tests. Stata/MP 16.1 was used for analysis. A p-value < 0.05 was considered significant.

Results

Over 550,000 RYGB and SG cases were analyzed. Readmission rate was 3-4%. Black race, RYGB, robotic-assisted approach and numerous comorbidities were independently associated with readmission (p<0.05). The most common reason for readmission was nausea, vomiting or abdominal pain among all racial/ethnic cohorts (39-51%), but was more common in black patients (p<0.001). Venous thromboembolism was the second leading cause for both overall and bariatric-related readmission, and was also higher in black (8.2-8.5%, p<0.001) compared to non-Hispanic white and Hispanic patients (Table 1).

Conclusions

Reasons for readmission after bariatric surgery vary by race/ethnicity, with leading causes of nausea, vomiting, abdominal pain and venous thromboembolism. The leading causes of readmission are more prevalent in black patients, and should be the focus practice guidelines.