Background

Readmissions after metabolic surgery are becoming increasingly important, as insurance companies use these metrics to exclude hospitals from performing bariatric surgery on covered patients. This can lead to decreased healthcare access for patients. We investigated patient factors associated with increased rates of readmission after metabolic surgery.

Methods

MBSAQIP patient use files, 2015-2018, were queried for all patients who underwent a primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). Rates of readmission were compared for different preoperative characteristics. Multivariable logistic regression was used to test for independence. Significance was considered at p<0.05

Results

Multiple preoperative patient factors were independently associated with readmission after LSG or LRYGB. History of DVT, use of therapeutic anticoagulation, history of cardiac surgery, COPD, dialysis dependence or renal insufficiency, and black vs white race were significantly associated with increased odds of readmission. Having a LSG vs LRYGB was associated with decreased odds of readmission.

Conclusions

Minimizing readmissions after weight loss surgery is important for improving patient outcomes and also for meeting insurance company guidelines to maintain access for patients seeking weight loss surgery. We have identified risk factors for readmission after LSG and LRYGB. Further studies are needed to understand how to use this information to identify high-risk patients and develop appropriate protocols to reduce readmission.