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Obesity Surgery

, Volume 29, Issue 1, pp 15–22 | Cite as

A Nationwide Safety Analysis of Discharge on the First Postoperative Day After Bariatric Surgery in Selected Patients

  • Jessica Ardila-Gatas
  • Gautam Sharma
  • S. Julie-Ann Lloyd
  • Zhamak Khorgami
  • Chao Tu
  • Philip R. Schauer
  • Stacy A. Brethauer
  • Ali Aminian
Original Contributions
  • 138 Downloads

Abstract

Background

Enhanced recovery after surgery has led to early recovery and shorter hospital stay after laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). This study aims to assess feasibility and outcomes of postoperative day (POD) 1 discharge after LRYGB and LSG from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) 2015 dataset.

Methods

Patients who underwent elective LRYGB and LSG and were discharged on POD 1 and 2 were extracted from the MBSAQIP dataset. A 1:1 propensity score matching was performed between cases with POD 1 vs POD 2 discharge, and the 30-day outcomes of the cohorts were compared.

Results

A total of 80,464 patients met the study criteria: 8862 LRYGB and 31,370 LSG cases, which were discharged on POD 1, and matched 1:1 with those discharged on POD 2. Within the LRYGB cohort, patients discharged on POD 2 had higher all-cause morbidity (7.5% vs 6.1%; p < 0.001) and 30-day re-intervention (2.0% vs 1.5%; p = 0.004) in comparison with patients discharged on POD 1. There were no statistical differences with respect to serious morbidity (0.5% vs 0.4%; p = 0.15), 30-day readmission (4.9% vs 4.5%; p = 0.2), and 30-day reoperation (1.3% vs 1.2%; p = 0.7). Within the LSG cohort, patients discharged on POD 2 had higher all-cause morbidity (4.2% vs 3.4%; p < 0.001), serious morbidity (0.4% vs 0.3%; p < 0.001), 30-day re-intervention (1.0% vs 0.6%; p < 0.001), and 30-day readmission (2.9% vs 2.5%; p = 0.002) in comparison with patients discharged on POD 1.

Conclusions

Early discharge on POD 1 may be safe in a selective group of bariatric patients without significant comorbidities.

Keywords

Morbid obesity Gastric bypass Roux-en-Y RYGB Complication, enhanced recovery, readmission, sleeve gastrectomy, bariatric 

Notes

Compliance with Ethical Standards

The Institutional Review Board approved this study under exempt status, as the data were publically available in a de-identified manner.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval Statement

For this type of study formal consent is not required.

Informed Consent Statement

This study does not require informed consent.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Bariatric and Metabolic Institute, Department of General SurgeryCleveland ClinicClevelandUSA
  2. 2.Department of Surgery, College of MedicineUniversity of OklahomaTulsaUSA
  3. 3.Department of Quantitative Health Sciences, Lerner Research InstituteCleveland ClinicClevelandUSA

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