title: Predictors of Hospital Readmission after Bariatric Surgery.
abstract: BACKGROUND
  Identification of factors that might predict readmission after bariatric surgery could help surgeons target high-risk patients. The purpose of this study was to identify comorbidities, surgical variables, and postoperative complications associated with readmission.
  
  
  METHODS
  Patients with bariatric surgery as their primary procedure were identified from the 2012 American College of Surgeons (ACS) NSQIP database. Patient variables, operative times, and major postoperative complications were analyzed for predictors of readmission. The ACS NSQIP estimated probability of morbidity (MORBPROB) was also considered. Chi-square tests and Poisson regression were used for statistical analysis to identify significant predictors.
  
  
  RESULTS
  There were 18,186 patients who met inclusion criteria. There were 1,819 who had a laparoscopic gastric band, 9,613 who had laparoscopic Roux-en-Y gastric bypass (RYGB), 6,439 who had gastroplasties (vertical banded gastroplasty and sleeve), and 315 who had open RYGB. Age, sex, BMI, American Society of Anesthesiologists (ASA) class, diabetes, hypertension, steroid use, type of procedure, and operative time all were significantly associated with readmission within 30 days of operation. All major postoperative complications were significant predictors of readmission. Patients expected to be at high risk based on the ACS NSQIP MORBPROB had a significantly higher rate of readmissions. The overall readmission rate for patients undergoing bariatric surgery was 5%. The readmission rate among patients with any major complication was 31%.
  
  
  CONCLUSIONS
  Bariatric surgery is a low-risk procedure. Complexity of operation, ASA class, prolonged operative time, and major postoperative complications are important determinants of high risk for readmission. The ACS NSQIP MORBPROB may be a useful tool to identify and target patients at risk for readmission.
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY. Electronic address: abrahac@mail.amc.edu.
authors.forename: Christa R
authors.initials: CR
authors.lastname: Abraham
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Werter
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Ashar
authors.initials: A
authors.lastname: Ata
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Yusef M
authors.initials: YM
authors.lastname: Hazimeh
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Ujas S
authors.initials: US
authors.lastname: Shah
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Avinash
authors.initials: A
authors.lastname: Bhakta
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Marcel
authors.initials: M
authors.lastname: Tafen
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Singh
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Todd D
authors.initials: TD
authors.lastname: Beyer
authors.affiliation: Department of Surgery, Albany Medical College, Albany, NY.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Stain
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050110:Bariatric Surgery; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D011183:Postoperative Complications; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult