Predictive factors for readmission after bariatric surgery: Experience of an obesity center

Abstract

Avoidable readmissions after bariatric surgery are a major burden on the healthcare systems. Rates of readmission after bariatric surgery have ranged from 1% up to 20%, but the factors that predict readmission have not been well studied. The objective of this study was to determine readmission rates following bariatric surgery and identify factors that contribute to early (within 90 days of surgery) and late readmission. A retrospective cohort study of 736 patients undergoing either Laparoscopic Sleeve Gastrectomy or Laparoscopic Roux-en-Y Gastric Bypass in Jordan University Hospital from 2016 to 2019. Demographic characteristics, co-morbidities, and readmissions were extracted from their medical records and analyzed. Multivariable logistic regression analysis was performed to determine which factors predict readmission. A total of 736 patients had bariatric surgery (Laparoscopic Sleeve Gastrectomy 89% vs Laparoscopic Roux-en-Y Gastric Bypass 11%) during the study period. Thirty-day readmission rate was 6.62% and an overall readmission rate of 23.23%. Common reasons for early readmission (within 90 days of surgery) were nausea, vomiting, and dehydration. Late readmissions were mainly caused by gallbladder stones. Three risk factors were identified that independently predicted readmission: the type of procedure being performed (P-value = .003, odds ratio [OR] 2.14, 95% confidence interval [CI] 1.32-3.49), depression (P-value = .028, OR 6.49, 95% CI 1.18-52.9) and preoperative body mass index (P-value = .011, OR 1.03, 95% CI 1.01-1.05). Several factors were identified that cause patients to represent and subsequently admitted into hospitals. Early readmission was usually due to nausea, vomiting, and dehydration, whereas late admissions were mostly due to biliary complications. Preoperative body mass index and depression were independent risk factors for readmission.