S Suh, BS, M Helm, MS, T L Kindel, MD, PhD, M I Goldblatt, MD, J C Gould, R M Higgins, MD. Medical College of Wisconsin
Introduction: The primary objective of this study was to determine the impact of nausea on post-operative outcomes in bariatric surgery patients.
Methods: A retrospective chart review was conducted of adult patients who underwent a primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or sleeve gastrectomy (LSG) between 2014 and 2017 at a single institution. Post-operative nausea was defined as patients who had nausea reported by the patient and documented by providers in the medical record as nausea requiring medications, or emesis. Univariate analyses were performed to determine the impact of post-operative nausea on patients’ length of stay, readmissions, reoperations and overall complications.
Results: There were 449 total primary bariatric surgery patients in the study period. Of these patients, 160 (35.6%) had documented post-operative nausea. Demographic factors that contributed to post-operative nausea included non-white race and undergoing a LSG (p=0.007 and p=0.001, respectively) (Table 1). Non-white patients had a 1.8 times increased risk of experiencing post-operative nausea compared to white patients (p=0.007). Patients who underwent a LSG had a 2.0 times increased risk of post-operative nausea compared to LRYGB (p=0.001). Patients with documented nausea had a statistically significant increased length of stay for LRYGB and LSG alone, as well as combined (2.4 ± 1.9 days vs 1.6 ± 1.0 days; p=<0.0001). Documented nausea patients were also more likely to have an upper endoscopy and Emergency Department visit within 30 days post-operatively (p=0.007 and p=0.02, respectively).
Conclusions: Post-operative nausea was more likely in non-white patients and those who underwent a LSG. Patients with documented nausea had increased length of stay, more upper endoscopies and Emergency Department visits. These results highlight the need for a metric to more accurately measure post-operative nausea, as well as a standardized anti-emetic pathway to improve quality outcomes.
Table 1. Demographic variables and perioperative outcomes in patients with and without documented nausea
*Indicates statistical significance (p≤0.05)
|
No documented nausea (n=289) |
Documented nausea (n=160) |
p-value | |
| Race (non-white) | 67 (23.2%) |
56 (35%) |
0.007* |
| Procedure type (LSG) | 145 (50.2%) |
107 (66.9%) |
0.001* |
| Length of stay (days) | 1.6±1.0 |
2.4±1.9 |
<0.0001* |
| Emergency department visit | 28 (9.7%) |
28 (17.5%) |
0.02* |
| Post-operative intervention (upper endoscopy) | 0 (0%) |
4 (2.5%) |
0.007* |
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91845
Program Number: S052
Presentation Session: Bariatric I – Complications
Presentation Type: Podium