Andrew Bates, MD, Jie Yang, PhD, Lizhou Nie, BS, Salvatore Docimo, Jr., DO, Konstantinos Spaniolas, MD, Aurora Pryor, MD. Stony Brook University Hospital
Introduction: The prevalence of substance abuse in bariatric patients has been well-documented in the literature. Several studies have alerted to the development of postoperative substance abuse in a small subset of bariatric patients. However, to what degree substance abuse affects patients’ postoperative outcomes and utilization of additional surgical procedures remains unclear.
Methods: We performed a retrospective review of a large-scale, state-based longitudinal hospital claims database (SPARCS) with mandatory reporting. All patients undergoing bariatric surgery between 2004 and 2010 were collected and outcomes were followed until 2014. Patients who had a diagnosis code for substance abuse within the previous 5 years before surgery were collected. Patients with revisional surgery, age less than 18, or lack of follow-up were excluded. Rates of subsequent surgery and postoperative outcomes were analyzed. Multivariate analysis was performed to control for procedural and patient variables.
Results: A total of 40,994 non-revisional bariatric patients were identified via inpatient and outpatient records. Patients with a previous diagnosis of substance abuse were shown to have longer lengths of stay following the index bariatric surgery (2.56 v. 1.96 days, p<0.0001) and higher overall complication rate (7.45% v. 5.28%, p<0.0001). Patients with substance abusewere more likely to undergo additional surgery after all types of bariatric procedures (p<0.0001). Among all bariatric patients who underwent subsequent surgery, substance abuse patients had a shorter time interval to additional surgery (337 v. 479 days, p<0.0001). Substance abuse patients had a higher rate of subsequent laparoscopic cholecystectomy and esophagogastroduodenoscopy (EGD), but no difference in rates of diagnostic laparoscopy or hernia repairs.
Conclusion: Bariatric surgery patients with a history of previous substance abuse experience a higher risk of postoperative complications and need for additional surgery, particularly laparoscopic cholecystectomy and EGD. These patients may require additional resources should they be deemed acceptable candidates for bariatric surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87895
Program Number: P659
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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