Miloslawa Stem, MS, James Taylor, MBBChir, MPH, Canner K Joseph, MSH, Alisa Coker, MD, Michael Schweitzer, MD, Gina L Adrales, MD, MPH. Johns Hopkins University School of Medicine
INTRODUCTION: Bariatric patients are discharged frequently within one postoperative day. The aim of this study was to compare the safety of outpatient laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) and to identify patients at risk for complications.
METHODS AND PROCEDURES: Adult patients with obesity (BMI≥35) who underwent an elective outpatient LSG or LRYGB were identified using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2015. Multivariable logistic regression analysis was performed to identify risk factors for 30-day overall morbidity and readmission (2011-2015) for each procedure type.
RESULTS: 27,423 patients were included, with 58.72% of LSGs and 41.28% LRYGBs. The outpatient rate increased over time for LSG (20.33% in 2010 to 37.34% in 2015, p<0.001) and LRYGB (13.92% in 2005-6 to 19.80% in 2015, p<0.001). In comparison to LSG, LRYGB patients had significantly higher rates of overall morbidity (2.71% vs. 1.85%, p<0.001) and readmission (4.44% vs. 2.62%, p<0.001). LSG: patients with ASA IV-V, dyspnea, steroid use, and bleeding disorder had significantly increased risk of overall morbidity; while black race, COPD, dyspnea and bleeding disorder had significantly increased risk of readmission (TABLE). LRYGB: patients with BMI≥50 and hypertension had increased risk of overall morbidity; while bleeding disorder had increased risk of readmission.
CONCLUSION: Outpatient LSG carries a lower risk for morbidity and readmission than LRYGB. Although morbidity and readmission rates were acceptable for both procedures, patients with the identified risk factors should be more closely monitored. Bleeding disorder posed the greatest risk and may warrant a longer hospital stay.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86368
Program Number: P648
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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