Hospital admission after gastric bypass: a nationwide cohort study with up to 6 years follow-up

Abstract

BACKGROUND Several studies have addressed short-term admission rates after bariatric surgery. However, studies on long-term admission rates are few and population based studies are even scarcer. OBJECTIVE The aim of this study was to assess short and long-term admission rates for gastrointestinal surgery after gastric bypass in Sweden compared to admission rates in the general population. SETTING Swedish healthcare system. METHODS The surgery cohort consisted of adults with Body Mass Index (BMI) ≥35 identified in the Scandinavian Obesity Surgery Registry (SOReg; n=28,331; mean age 41y; 76% women; Roux-en-Y gastric bypass performed 2007–2012). For each individual, up to 10 comparators from the general population were matched on birth year, sex, and place of residence (n=274,513). The primary outcome was inpatient admissions due to gastrointestinal surgery retrieved from the National Patient Register through December 31, 2014. Conditional hazard ratios (HR) were estimated using Cox regression. RESULTS All-cause admission rates were 6.5%, 21.4% and 65.9% during 30d, 1, and 6 years after surgery. The corresponding rates for gastrointestinal surgery were 1.8%, 6.8%, and 24.4%. Compared to the general population, there was an increased risk of all-cause hospital admission at 1 year (HR 2.6 [2.5–2.6]) and 6 years (HR 2.7 [2.6–2.7]). The risk of hospital admission for any gastrointestinal surgical procedure was greatly increased throughout the study period (HR 8.6 [8.4–8.9]). Female sex, psychiatric disease, and low education were risk factors. CONCLUSION We found a significant risk of admission to hospital over more than 6 years after gastric bypass surgery.

Differences in Health-Related Quality of Life After Gastric Bypass Surgery: a Cross-Sectional Study

“…The fact that individuals on sick leave and long-term disability support in the present material reported low HRQoL may also be due to factors related to concurrent illness [ 27 ]. Low educational level is also associated with increased risk for hospital admission after GBP surgery [ 28 ]. However, inferior HRQoL in these groups may also be due to less %EBMIL which present data indicates when comparing the domains in RAND-36 and weight loss since surgery.…”

Abdominal Pain After Roux-En-Y Gastric Bypass for Morbid Obesity

“…Patient-reported experience of abdominal pain both prior to and after RYGB should be the focus of future studies. An increased need for abdominal surgery during 6 years post RYGB indicates a potential effect of time that needs further exploration (10).…”

“…A Swedish register study of 28,331 patients (median follow-up 3.6 years) found an increased risk for hospital admission for gastrointestinal surgery after RYGB (relative risk 8.6). About one in four patients had additional abdominal surgery during 6 years of follow-up (10). In a Danish study, 67.6% of patients contacted health care after RYGB due to symptoms, and 29% had been hospitalized.…”

Gender as a Deterministic Factor in Procedure Selection and Outcomes in Bariatric Surgery

“… 18 – 20 In a study by Aman et al, 20 female gender made up 78.9% of all 30-day readmissions following bariatric surgery over a two-year period from 2012 to 2013. 21 The present study demonstrates that females made up 55.5% of 30-day readmissions over a two-year period from 2015 to 2017. It is important to note that although female patients continue to make up the majority of 30-day readmissions, this has decreased substantially.…”

“…According to Bruze et al, when compared to the general population, female patients continue to exhibit higher all-cause readmission rates even six years following surgery. 21 Prior studies have demonstrated a relationship between independent pre-operative psychosocial factors which affect the likelihood of readmission following bariatric surgery. Such factors have little to do with the surgical procedure itself, and more to do with unrelated demographic characteristics that may not be immediately obvious during pre-operative assessment.…”