• 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
    • 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
  • Store
    • SAGES Logo Products
    • “Unofficial” Logo Products
  • Log In

Is discharge within 1 day after gastric bypass safe? Results of a propensity-matched analysis from the MBSAQIP Participant Use File.

Julietta H Chang, MD, Elan R Witkowski, MD, MS, Matthew M Hutter, MD, MPH. Massachusetts General Hospital

Introduction: As Roux-en-Y gastric bypass (RYGB) procedures have become safer, postoperative length of stay (LOS) has decreased. Reducing LOS must be balanced by the risks of developing or recognizing postoperative complications outside of a hospital setting, and the risks of readmissions. The national average length of stay after LRYGB is 2.2 days (i.e. being discharged on POD#2), but single institution studies have shown that shorter hospital stays after surgery is safe. The MBSAQIP captures data on all cases performed at participating centers with clinically rich, standardized data collected by audited and trained clinical reviewers.  A Participant Use File with patient-level 30-day postoperative outcomes from calendar year 2015 is now available.  The objective of this study was to analyze the 30-day postoperative outcomes for patients who were discharged within 1 day after LRYGB, compared to patients who were discharged later.

Methods: Patients were categorized within two groups: those discharged within one day after surgery (POD#1 or less) vs those discharged 2-3 days after surgery (POD#2-3). Patients with LOS>3 days were excluded to minimize confounding. Patient characteristics, intraoperative data, and 30-day postoperative outcomes were analyzed with univariate analyses. Propensity matched modeling was done matching on the characteristics of patients discharged on POD#1 earlier.

Results: 45,368 nonemergent primary RYGB were performed in 2015. 37,647 (83.0%) were discharged within 3 days of surgery, of which 10,988 patients (24.2% of total) were discharged on POD#1 or earlier and 26,659 patients (58.8% of total) on POD#2-3. Unadjusted postoperative outcomes reveal decreased readmissions in the POD#1 or less group (4.75% vs 6.04%; p<0.001), as well as fewer major complications (3.15% vs 4.54%; p<0.001). Propensity-matched cohort analysis showed that rates of readmissions in the POD#1 or less group remained lower (4.74% vs 5.75%; p=0.004), as did rates of major complications (3.13% vs 4.60%; p<0.001).

Conclusion: This propensity-matched analysis of patients at MBSAQIP accredited centers reveals that early discharge after LRYGB is now being performed regularly (27% of the time), and is safe in appropriately selected patients.  Major complication rates and readmissions rates were actually decreased in patients discharged within one day.  This suggests that surgeons who discharge patients by POD#1 are identifying the right patients with an appropriate early postoperative course to discharge within one postoperative day.  It does not imply that all patients should be discharged on POD#1, or that early postoperative signs, symptoms or studies should be ignored in making the decision for discharge.


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

Abstract ID: 88150

Program Number: P627

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

10

Share this:

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

Related

« Return to SAGES 2018 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