Rates and Predictors of 30-Day Readmissions in Patients Undergoing Bariatric Surgery in the US: a Nationwide Study

Background Among various therapeutic options for morbid obesity, bariatric surgery (BS) is now considered one of the most effective methods of weight loss. We decided to perform an analysis to look at 30-day all-cause readmission and independent predictors of readmission in patients undergoing BS. Methods We queried the 2017 Nationwide Readmission Database (NRD) using ICD-10-CM diagnosis codes to identify all adult patients who underwent BS from January 1 to November 30, 2017. Outcomes assessed were 30-day readmission rates, mortality, length of stay (LOS) and hospitalization costs, and independent predictors of readmission. Results A total of 182,848 adult patients underwent BS during hospitalization in 2017, with in-hospital mortality rate of 0.52% (951). Of the patients discharged, 4.99% (9088) patients were readmitted within 30 days. The most common primary diagnosis at readmission was Other complications of other bariatric surgery. When compared with index admission, readmitted patients had higher in-hospital mortality (0.52% vs 2.06%,p < 0.01), increased mean LOS (2.94 days vs 5.94 days,p < 0.01) but lower mean hospitalization charges ($67,763 vs $66,065,p < 0.01). Increasing age (HR 1.01, 95% CI: 1.006-1.014,p < 0.01), longer LOS (HR 1.01, 95% CI: 1.008-1.014,p < 0.01), higher comorbidity score (HR 1.15, 95% CI: 1.12-1.18,p < 0.01), CHF (HR 1.19, 95% CI: 1.01-1.42,p < 0.05), and AKI (HR 1.64, 95% CI: 1.34-2.02,p < 0.01) were independently associated with increased likelihood of 30-day readmission. Conclusion This study shows that almost 5% patients undergoing bariatric surgery are readmitted within 30 days of discharge in the US. Further studies are needed to assess the high-risk populations to understand the reasons predisposing to early readmission.

Automated summary

The study found that nearly 5% of patients undergoing bariatric surgery in the US are readmitted within 30 days of discharge. Readmitted patients had higher in-hospital mortality, longer length of stay, but lower hospitalization costs. Age, length of stay, comorbidity score, congestive heart failure, and acute kidney injury were independently associated with an increased likelihood of 30-day readmission.