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Trends, Outcomes, and Impact of Early Discharge Following Bariatric Surgery: a Retrospective MBSAQIP Analysis of 748,955 Patients

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Abstract

Introduction

Decreasing the length of stay following bariatric surgery can reduce pressure on hospitals and surgical costs and increase patient satisfaction. We examine trends in length of hospital stay following bariatric surgery and in post-operative complications.

Methods and Procedures

The 2015–2019 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was used to compile patients undergoing Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy. Patients were categorized into either early discharge (within one day of surgery) or late discharge, and patient and non-patient factors were compared between the two groups. A multivariable logistic regression was carried out to determine predictive factors for early discharge.

Results

We evaluated 748,955 patients, with 399,918 (53%) being discharged early. Patients discharged early were younger and had fewer associated medical problems. The rate of early discharge increased between 2015 and 2019 (42.1% in 2015 vs 62.0% in 2019), while complication rates decreased or were unchanged. Multivariable analysis revealed lower ASA classification (OR 1.07; CI 1.06–1.09; p < 0.0001) and operative year (2019 vs. 2015 OR 2.26; CI 2.22–2.29; p < 0.0001) to be independently associated with early discharge. Several factors including undergoing RYGB (OR 0.44 CI 0.44–0.45; p < 0.0001), and dialysis dependence (OR 0.50; CI 0.45–0.55; p < 0.0001) among others, were associated with reduced early discharge likelihood.

Conclusions

There is a trend in bariatric surgery towards the practice of early discharge, which is safe for patients. Further work is needed to develop a set of criteria to determine which patients are best suited for this practice.

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Authors and Affiliations

  1. Faculty of Medicine and Dentistry, University of Alberta, University of Alberta Hospital, 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada

    Kieryn Houlder

  2. Department of Surgery, University of Alberta, Edmonton, AB, Canada

    Valentin Mocanu, Kevin Verhoeff, Gabriel Marcil, Daniel W. Birch, Shahzeer Karmali & Noah J. Switzer

Authors
  1. Kieryn Houlder
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  2. Valentin Mocanu
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  3. Kevin Verhoeff
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  4. Gabriel Marcil
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  5. Daniel W. Birch
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  6. Shahzeer Karmali
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  7. Noah J. Switzer
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Corresponding author

Correspondence to Kieryn Houlder.

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Ethics Approval and Consent to Participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As this was a retrospective study, formal consent was not required.

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The authors declare no competing interests.

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Key Points

- Decreased admission length benefits the patient and healthcare system.

- From 2015 to 2019 rates of early discharge increased, and complications decreased.

- Early discharge is safe for bariatric patients.

- Further development of a criteria for patient selection is necessary.

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Houlder, K., Mocanu, V., Verhoeff, K. et al. Trends, Outcomes, and Impact of Early Discharge Following Bariatric Surgery: a Retrospective MBSAQIP Analysis of 748,955 Patients. OBES SURG 32, 2572–2581 (2022). https://doi.org/10.1007/s11695-022-06108-7

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  • DOI: https://doi.org/10.1007/s11695-022-06108-7

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