Emergency department (ED) utilization following bariatric surgery is an important quality metric. Many ED visits do not result in admission and are therefore thought to be preventable. Objective: We aimed to investigate what preoperative factors, specifically preoperative ED utilization, may influence patients' ED utilization after bariatric surgery.


We queried the Michigan Bariatric Surgery Collaborative (MBSC) for all patients who underwent bariatric surgery at Henry Ford Health System from 1/1/2016 - 12/31/2018. The primary outcome of the study was ED presentation within 30 days after surgery. Multivariate linear regression was then performed to identify independent predictors for ED presentation.


Of the 1812 patients, 81 (4.5%) presented to the ED within 30 days. Among all patients, 1278 (76%) underwent laparoscopic sleeve gastrectomy (LSG) while the remaining 434 (24%) underwent Roux-en-Y gastric bypass (LRYGB). The pre-operative factors associated with post-operative ED presentation included asthma (35.8 % vs 25.6%), public insurance (19.8% vs 10.6%), and pre-operative ED utilization (33.3% vs 15.1%). Pre-operative ED utilization was the only identified independent predictor for post-operative ED presentation (OR: 2.8, 95% CI: 1.7-4.6).


Presentation to the ED within 1 year prior to bariatric surgery was an independent predictor of post-operative ED presentation. Further studies exploring pre-operative factors may help identify patients that are at high risk for post-operative ED presentation. This may allow for a point of intervention to help reduce post-operative ED utilization.