Analysis of Causes and Risk Factors for Hospital Readmission After Roux-en-Y Gastric Bypass.

Abstract

Identification of causes and preventable triggers for hospital readmission after bariatric surgery is very important to implement strategies for surgical outcome optimization. The aim of the study was to analyze our readmissions after a Roux-en-Y gastric bypass (RYGB). From our prospectively constructed database, patients who were readmitted to the hospital within the following 30 and 90 days after discharge were analyzed. Hospital charts were reviewed to determine the cause of readmission and the outcome. Potential risk factors for readmission were statistically analyzed. Between June 2004 and November 2013, 657 patients underwent a primary RYGB and 100 revisions. There were 442 (58%) females and 315 (42%) males with a mean age of 40.1 ± 11.5 years and a mean BMI of 42.4 ± 6.5 Kg/m(2). Comorbidities were present in 441 (58.2%) patients. Operations were completed laparoscopically in 741 (97.8%) patients. Mean hospital stay after the RYGB was 2.5 ± 1.6 days. The 30-day and 90-day readmission rate was 2.6 and 4.58%, respectively. Most common causes for readmission at 30 days were gastrointestinal bleeding in 30%, lung disease in 15%, and food intolerance in 15%. At 90 days, they were stricture of the gastrojejunostomy in 20%, gastrointestinal bleeding in 13.3%, and nephrolithiasis in 13.3%. Open surgery and previous upper abdominal surgery were significant risk factors for 90-day readmission. Our readmission rate after RYGB was low. Most common causes for readmission were upper gastrointestinal bleeding and food intolerance. Associated risk factors were open surgery and previous upper abdominal surgery.