Patrick N Salibi, MD1, Thomas C Robertson, MD2, Daniel Hyatt, MD1, Sajen Alexander1, John Elliot1, Thomas Sonnanstine, MD1. 1Riverside Methodist Hospital, 2Carolinas Medical Center
Introduction: The purpose of this study is to determine the risk factors that contributed to increased postoperative complications, as noted in prior studies within the publicly funded insurance population undergoing bariatric surgery.
Methods and Procedures: Data was collected via a retrospective review of the medical records of patients who underwent laparoscopic roux en y gastric bypass or laparoscopic sleeve gastrectomy from 2010-2014 at a single institution. For each patient, data was collected in the following categories: baseline demographics, insurance status, medical comorbidities, immediate complications, re-admissions and associated complications, and follow up out to 3 years.
Results: A total of 553 patient charts were reviewed, 513 patients were categorized as private insurance and 40 patients were categorized as public insurance. There was no statistically significant difference in mean patient age (private 46.6 years vs public 48 years), sex (male:female 22%:78% for both groups), or BMI (48 vs 50). There was a statistical significance in relationship status in the categories of single (21% vs 30%), married (61% vs 35%) or living with a partner (3% vs 10%), as well as employment status (78% vs 12%). When comparing comorbid conditions preoperatively there was no difference except for diabetes which was less common in the private insurance group 32% vs 50%. Readmission rates for complications were significantly different as well at 35% vs 55% with public insurance patients having increased complication rates and readmissions. There was no difference in follow up percentages at each time point for the two groups. Interestingly postoperative BMI was significantly different in the two groups until 1 year out (32 vs 34) when the difference disappears.
Conclusions: Our current data set confirms prior research that documented higher complication rates in public insurance patient populations without differences in long term results in regards to weight loss. It also shows that the public insurance group is possibly at higher risk for complications and readmissions postoperatively due to the lack of social support at home given that a much higher percentage of them are single or divorced, and lack employment. It is likely that this lack of support at home prompts more frequent readmissions and associated complications.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88272
Program Number: P598
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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