- •A total of 569,652 patients were readmitted with racial group and procedure predictive of all-cause readmission (Table 3). Non-Hispanic Black [OR 1.52; 95% CI: 1.47-1.58] or Hispanic [OR 1.14; 95% CI: 1.09-1.19] were more likely to be readmitted when compared to non-Hispanic White adults.
- •LSG [odds ratio (OR) 1.27; 95% confidence interval (CI): 1.10-1.48] and RYGB (OR 2.24; 95% CI: 1.93-2.60) were associated with readmission compared to LAGB. Robotic approach increased from 6.2% in 2015 to 9.8% in 2018 (p<0.0001). LOS > 3 days occurred in 2.9% of laparoscopic procedures vs 3.2% of robotic procedures (P=0.001). The rate of readmission was 3.7% for laparoscopy and 4.3% for robotic surgeries (P<0.0001).
- •Men comprised < 22% of the total cohort every year. Men, especially Black men, were more likely to present with a BMI ≥ 50kg/m2 compared to women. Interestingly, male gender was protective for readmission (OR 0.87; 95% CI: 0.84-0.90]. It is critical to understand that Black patients, in particular Black men, experience a prolonged LOS more often than White patients.
- •Further investigation into the intersectionality of race and gender would provide a better understanding of disparities in access and outcomes for bariatric surgery patients. Future studies should review the effects of enhanced recovery protocols across racial groups to better understand readmission after bariatric surgery.
Readmission after bariatric surgery is multifactorial. Understanding the trends in risk factors for readmission provides opportunity to optimize patients prior to surgery identify disparities in care, and improve outcomes.
This study compares trends in bariatric surgery as they relate to risk factors for all-cause readmission.
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) participating facilities.
The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was used to analyze 760,076 bariatric cases from 854 centers. Demographics and 30-day unadjusted outcomes were compared between laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (LSG), and Roux-en-Y gastric bypass (RYGB) performed between 2015 and 2018. A multiple logistic regression model determined predictors of readmission.
A total of 574,453 bariatric cases met criteria, and all-cause readmission rates decreased from 4.2% in 2015 to 3.5% in 2018 (P < .0001). The percentage of non-Hispanic Black adults who underwent bariatric surgery increased from 16.7% of the total cohort in 2015 to 18.7% in 2018 (P < .0001). The percentage of Hispanic adults increased from 12.1% in 2015 to 13.8% in 2018 (P < .0001). The most common procedure performed was the LSG (71.5%), followed by RYGB (26.9%) and 1.6% LAGB (1.6%) (P < .0001). Men were protected from readmission compared with women (odds ratio [OR]: .87; 95% confidence interval [CI]: .84–.90). Non-Hispanic Black (OR: 1.52; 95% CI: 1.47–1.58)] and Hispanic adults (OR: 1.14; 95% CI: 1.09–1.19) were more likely to be readmitted compared with non-Hispanic White adults. LSG (OR: 1.27; 95% CI: 1.10–1.48) and RYGB (OR: 2.24; 95% CI: 1.93–2.60) were predictive of readmission compared with LAGB.
Readmission rates decreased over 4 years. Women, along with non-Hispanic Black and Hispanic adults, were more likely to be readmitted. Future research should focus on gender and racial disparities that impact readmission.
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Published online: January 06, 2022
Accepted: December 30, 2021
Received: August 15, 2021
© 2022 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
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- Comment on: Trends in risk factors for readmission after bariatric surgery 2015–2018Surgery for Obesity and Related DiseasesVol. 18Issue 5
- PreviewIn 2021, bariatric surgery is the most effective treatment for obesity and its related co-morbidities. Despite objective advances in safety  and rapid growth in the number of eligible patients, surgical treatment continues to be viewed as the option of last resort by many physicians and nonphysicians alike, with only 0.5% of eligible patients undergoing a bariatric operation in 2016 .