Altieri MS, et al. – This study was performed to assess the indications for and incidence of both emergency department (ED) visits and hospital readmissions within the first postoperative year. Researchers also aimed at identifying the rate of reoperation within the first 3 years following a SG operation in New York State (NYS). They realized increasing popularity of SG in NYS. Despite high postoperative ED visits, SG had a low overall reoperation rate (0.32%), and of these patients, most undergo conversion to RYGB compared to sleeve revision. Overall 1–year readmission rates after SG are 12.5%.

Methods

• Researchers examined the SPARCS database for all SGs performed between 2011 and 2013.
• Patients were followed for at least 1 year using a unique identifier.
• They also followed patients for reoperation and/or conversion to Roux–en–Y Gastric Bypass (RYGB), as well as for any other hospital–based encounter.
• The top five reasons for ED visits and readmission were identified using primary diagnosis codes.

Results

• 14,080 SG were identified between 2011 and 2013.
• One–third of patients visited the ED (33.9%).
• Researchers noticed that one in every ten of these visits resulted in readmission (9.5%), with 12.5% of the total postoperative patient population undergoing readmission within their first year after SG surgery.
• In just over half of the patients, ED visits were unrelated to surgery (n = 4977; 53.88%).
• However, ED visits for abdominal pain (n = 1029; 11.14%), vomiting (n = 237; 2.57%), dehydration (n = 224; 2.43%), and syncope (n = 206; 2.23%) were related to the surgery.
• Within the first year after SG, the top five causes for readmission were not associated to surgery (n = 1101; 41.74%), complication related to bariatric surgery (n = 211; 8%), dehydration (n = 171; 6.48%), postoperative wound complication (n = 89; 3.37%), abdominal pain (n = 78; 2.96%).
• Overall, observations revealed a low reoperation rate (0.32%); specifically, rates of sleeve revision and conversion to RYBG were 0.11 and 0.21%, respectively.