Patient perspectives on emergency department self-referral after bariatric surgery

Stevens, Haley; Wells, Emily; Ross, Rachel; Stricklen, Amanda; Ghaferi, Amir A.

doi:10.1016/j.soard.2018.01.015

Cited by 17 publications

(6 citation statements)

References 16 publications

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“…The rate of preventable ED visits in our study (61%) is similar to the previously reported rates [6,7]. Socioeconomic status, race, pulmonary disease, functional status, distance traveled to facility where procedure performed, and government funded insurance are often associated with an increased rate postoperative ED visits and readmissions [4,[12][13][14]. Age has also been implicated, as both younger and older patients are susceptible to increased postoperative ED utilization either as a result of reduced compliance or higher degree of medical complexity [13].…”

Section: Discussionsupporting

confidence: 88%

Characterizing the preventable emergency department visit after bariatric surgery

Khouri

Alvárez

Matusko

et al. 2020

Surgery for Obesity and Related Diseases

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Section: Discussionsupporting

confidence: 88%

Characterizing the preventable emergency department visit after bariatric surgery

Khouri

Alvárez

Matusko

et al. 2020

Surgery for Obesity and Related Diseases

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“…Nausea and vomiting represented about 9% of the indications for ED visits in our study, as compared with 25% and 16.7% in other studies. 31,32 Fever was the indication for ED visits in 6% of patients in the present study, which was half the rate reported by other investigators. 32 A number of studies reported an association between gastrointestinal symptoms, such as nausea and vomiting, and ED visits.…”

Section: Discussionsupporting

confidence: 53%

Analysis of Emergency Department Visits and Unplanned Readmission After Bariatric Surgery: An Experience From a Tertiary Referral Center

Makki

Mahdy

Emile

et al. 2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Bariatric surgery is the most effective treatment of morbid obesity. As the number of bariatric procedures performed has increased, visits to the emergency department (ED) and readmissions have subsequently increased. The present study aimed to assess the rates and indications for of ED visits and readmission after bariatric surgery and to identify the predictors of hospital readmission.Patients and Methods: This was a retrospective cohort study on patients who underwent bariatric surgery from January 2018 to April 2020. The percentage of ED visits and unplanned readmission was estimated and the indications and management of each were analyzed. The association of age, sex, body mass index, and type of procedure with readmission was assessed.Results: Of 582 patients who underwent bariatric surgery in the study period, 204 (35%) required ED visits, and 42 (7.2%) required readmission. The mean age of patients was 33 years, and the mean body mass index was 43 kg/m 2 . The most common indication for ED visits was abdominal pain (41.2%). In all, 64.8% of ED visits and 43% of readmissions were unrelated to bariatric surgery complications. A total of 94.1% of patients who required ED visits and 71.4% of readmitted patients were managed conservatively. The most common procedure followed by readmission was laparoscopic sleeve gastrectomy (50%) then one-anastomosis gastric bypass (21.4%). Age, sex, body mass index, and procedure type were not significantly associated with higher readmission. Conclusions:The rates of ED visits and readmission in our cohort were 35% and 7.2%, respectively. Most cases of ED visits were not related to adverse effects of bariatric surgery and the majority of which were managed conservatively.

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“…The reasons for this finding remain unclear and could not be elucidated from the database used for our study. In the published literature, the most common reported reasons for ED visits including abdominal pain, nausea/vomiting, dehydration, wound concerns, and compliance issues [26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“…In a recent prospective cohort study of patients in the Michigan Bariatric Surgery Collaborative (MBSC) database, Stevens et al [26] found that most ED presenting symptoms following bariatric surgery were of low acuity and non-life- threatening. Some studies have highlighted educational level as a possible contributor to poor compliance, resulting in higher readmission rates.…”

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery in Prior Solid Organ Transplantation Patients: Is Race a Predictor of Adverse Outcomes?

et al. 2020

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Purpose Metabolic and bariatric surgery (MBS) is increasingly performed in patients with previous solid organ transplantation (PSOT). In addition, controversy remains about whether racial disparity in outcomes following MBS exists. Therefore, the aim of this analysis was to determine if race independently predicts outcomes in MBS patients with PSOT. Materials and Methods Patients with PSOT undergoing sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) were identified in the 2017 Metabolic and Bariatric Surgery Accreditation Quality and Improvement Project (MBSAQIP) database. Patients were stratified by race (Black and White). Propensity score matching was utilized to adjust for multiple demographic variables. Multivariable logistic regression analyses were performed for overall and bariatric-related morbidity. Results Of 335 MBS patients with PSOT, 250 (75%) were white and 85 (25%) were black patents. Procedure-type and surgical approach (p > 0.1) were similarly distributed. Black patients were more likely (p < 0.05) to have hypertension dialysis-dependent chronic kidney disease, and be on chronic steroids). Mortality and morbidity were similar. Black patients had significantly (p < 0.05) higher rates of renal failure, pulmonary complications, and emergency department visits in unmatched analysis. After propensity score matching, 82 patients in each cohort were identified and were similar at baseline (p > 0.5). In the matched analysis, black patients had higher overall (17% vs. 10%, p = 0.12) and bariatric-related morbidity (14% vs. 7.2%, p = 0.05). In addition, black patients had significantly (p < 0.05) higher rates of postoperative pneumonias, progressive renal insufficiency, and emergency department visits. On multivariable regression analysis, black race did not independently predict overall or bariatric-related morbidity. Conclusion MBS in racial cohorts with PSOT is safe, with very low rates of overall morbidity and mortality. Black race trended toward increased postoperative morbidity. Larger cohort studies are needed to validate our findings.

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Patient perspectives on emergency department self-referral after bariatric surgery

Cited by 17 publications

References 16 publications

Characterizing the preventable emergency department visit after bariatric surgery

Characterizing the preventable emergency department visit after bariatric surgery

Analysis of Emergency Department Visits and Unplanned Readmission After Bariatric Surgery: An Experience From a Tertiary Referral Center

Bariatric Surgery in Prior Solid Organ Transplantation Patients: Is Race a Predictor of Adverse Outcomes?

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