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- Title
Postoperative Care Fragmentation Is Associated with Increased 30-Day Mortality after Bariatric Surgery.
- Authors
Sanaiha, Yas; Juo, Yen-Yi; Khrucharoen, Usah; Dutson, Erik; Chen, Yijun
- Abstract
Background: Compromised access following bariatric centers-or-excellence designations may have led to increased incidence of non-index readmissions and worsened care fragmentation. We seek to evaluate risk factors and impact of non-index readmissions on short-term mortality during readmission using a national bariatric registry data from 2015.Methods: A retrospective cohort study was performed using a national clinical database. Multivariate logistic regression models were developed to quantify association between non-index readmissions and 30-day mortality among bariatric patients with 30-day readmissions.Results: A total of 4704 patients were identified as undergoing bariatric surgery and readmitted within 30 days. Of these, 325 (6.9%) patients were readmitted to a non-index facility while the rest were hospitalized at the original hospital. Patient characteristics were largely similar between the two comparison groups, although patients with in-hospital complications and non-home disposition during the initial stay were more likely to experience non-index readmissions. Multivariate regression demonstrated that non-index readmission was associated with an adjusted odds ratio of 4.4 for 30-day mortality (95% confidence interval 2.6-9.2, p < 0.01). The most common reason for mortality for both index and non-index readmissions was pulmonary embolism.Conclusions: Care fragmentation may lead to increased 30-day mortality during readmissions following bariatric surgery. Heightened vigilance and longitudinal follow-up planning is recommended for patients with elevated risk for venous thromboembolism.
- Subjects
BARIATRIC surgery; POSTOPERATIVE care; PATIENT readmissions; MORTALITY; PULMONARY embolism; HEALTH services accessibility; MULTIVARIATE analysis
- Publication
Obesity Surgery, 2018, Vol 28, Issue 12, p3795
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-018-3419-1