Emergency department visits and readmissions within 1 year of bariatric surgery: A statewide analysis using hospital discharge records.

BACKGROUND: Data are limited regarding emergency department visits and readmission rates beyond 30 days after bariatric surgery. We analyzed emergency department visits and readmissions to all facilities in Wisconsin within 1 year of bariatric surgery and identified their predictors.

METHODS: All adults who underwent a laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy from 2011-2014 were identified. Bivariate associations between patient/hospital factors and emergency department visits/readmissions were examined, and factors significant at P < .1 were included in multivariable logistic regression models.

RESULTS: Within 1 year of bariatric surgery, 36.9% of emergency department visits and 60.3% of readmissions were to the same institution in which bariatric surgery was performed. The frequency of emergency department visits ranged from 10.7% (postoperative days 0-30) to 5.7% (postoperative days 181-270). Readmission rates ranged from 4.4% (postoperative days 0-30) to 2.7% (postoperative days 91-180). Readmission within 1 year was associated with male sex, Roux-en-Y gastric bypass, ≥4 comorbidities, Medicare insurance, teaching hospitals, and inpatient complications (all P < .05).

CONCLUSION: Emergency department visits and readmissions persist throughout the first year at a relatively steady rate after 30 days and often do not occur where bariatric surgery was performed. Quality improvement efforts targeting these patients may improve outcomes and decrease hospital resource utilization.