• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • 2022 NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • SAGES 2021 Annual Meeting
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2021
      • SAGES 2020
      • SAGES 2019
      • SAGES 2018
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
    • All Blog Posts
  • Log In

COMPLICATIONS AND READMISSION FOLLOWING SAME DAY DISCHARGE AFTER ELECTIVE LAPAROSCOPIC NISSEN FUNDOPLICATION

Tarik K Yuce, MD1, Ryan J Ellis, MD, MS1, Ryan P Merkow, MD, MS1, Nathaniel J Soper, MD2, Karl Y Bilimoria, MD, MS1, David D Odell, MD, MS1. 1Surgical Outcomes and Quality Improvement Center, 2Department of Surgery, Northwestern Memorial Hospital

Introduction: Traditionally, laparoscopic Nissen fundoplication (LNF) was associated with inpatient hospitalization. More recently, insurers and health systems have pushed for same day discharge. However, surgical outcomes in these patients are poorly understood. We describe the frequency of complications and readmission after same day discharge following elective Nissen fundoplication.

Methods and Procedures: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify all elective LNF from 2012 to 2016.  Patients discharged on the day of surgery were compared to those discharged on postoperative day (POD) 1 or 2. Outcomes studied included 30-day readmission and death or serious morbidity (DSM). Associations between same day discharge and both DSM and 30-day readmission were assessed using multivariable logistic regression. Readmission was further analyzed using Kaplan-Meier failure estimates and log-rank tests for equality.

Results: Of 7,734 patients who underwent elective LNF, 568 (7.3%) were discharged on the day of surgery. Patients were less likely to be discharged on the day of surgery if they had an ASA class >III (26.8% vs 36.6%, p<0.001), preoperative history of COPD (2.3% vs 4.6%, p=0.011), preoperative steroid use (2.1% vs 4.8%, p=0.004), or dyspnea (4.9% vs 9.0%, p=0.001). On multivariable analysis, there was no association between day of discharges and DSM (OR 0.91, 95% CI 0.36-2.29) or 30-day readmission (OR 0.97, 95% CI 0.62-1.52). While patients discharged on the day of surgery had higher unadjusted rates of early readmission, Kaplan-Meier analysis showed no difference in rates of hospital readmission between groups at 30-days from discharge (3.9% v 4.1%, p=0.325, Figure 1). The most common 30-day readmission diagnoses overall were nausea/vomiting (11.5%), dysphagia (11.1%), and abdominal pain (5.7%).

Conclusions: Same day discharge of patients following Nissen fundoplication was not associated with an increase in perioperative complications or 30-day readmission. However, an increase in early readmission following same day discharge may be present. Furthermore, interventions focused on improvement of postoperative abdominal pain along with prevention of nausea and vomiting may provide an opportunity to improve readmission rates. Future work focused on identifying patients least likely to have early readmission after same day discharge is warranted.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95088

Program Number: P458

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

View this Poster

85

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2019 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Surgery is Safer with Vaccination 1

Addressing Religious Concerns About COVID-19 Vaccine

This may be a difficult subject matter for you and your patient to talk about.  Be assured, all major organized religious groups encourage and recommend the COVID-19 vaccine. Listed below are references and websites you can direct your patient towards to help them make an informed decision with regards to their religious concerns against the […]

SAGES Statement on AAPI Violence

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) stands in solidarity with the Asian American and Pacific Islander (AAPI) community. In the summer of 2020, SAGES released a statement condemning the violence, racism, and hatred toward the Black community in the wake of George Floyd and Breonna Taylor’s murders. It is with great sorrow […]

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
[email protected]
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2022 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2022 Society of American Gastrointestinal and Endoscopic Surgeons