title: National prevalence, causes, and risk factors for bariatric surgery readmissions.
abstract: BACKGROUND
  Readmissions are often used as a quality metric particularly in bariatric surgery.
  
  
  METHODS
  Laparoscopic Roux en Y gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy were identified using Current Procedure Terminology codes in the 2012 National Surgical Quality Improvement Program public use file.
  
  
  RESULTS
  A total of 18,296 patients were included, 10,080 (55.1%) were laparoscopic Roux en Y gastric bypass, 1,829 (10.0%) were laparoscopic adjustable gastric banding, and 6,387 (34.9%) were laparoscopic sleeve gastrectomy. Among all patients, 955 (5.22%) were readmitted. Patients with readmissions had a higher proportion of body mass index greater than 50 (30.2% vs 24.6%, P < .001), higher index operative time (132 minutes vs 115, P < .001) and greater proportion with length of stay greater than 4 days (9.57% vs 3.36%, P < .001). Readmitted patients were more likely to have diabetes (31.1% vs 27.7%, P = .02), chronic obstructive pulmonary disease (2.63% vs 1.72%, P = .04), and hypertension (54.5% vs 50.8%, P = .03). Overall, 40.6% of readmitted patients had a complication. Common readmissions were gastrointestinal-related (45.0%), dietary (33.5%), and bleeding (6.57%). Readmission was independently associated with African-American race (odds ratio [OR] = 1.53, P = .02), complication (OR = 11.3, 95%, P < .001), and resident involvement (OR = .53, P = .04).
  
  
  CONCLUSIONS
  A 30-day readmission after bariatric surgery is prevalent and closely associated with complications.
authors.affiliation: Department of Surgery, Section of Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA.
authors.forename: Trit
authors.initials: T
authors.lastname: Garg
authors.affiliation: Department of Surgery, Section of Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA.
authors.forename: Ulysses
authors.initials: U
authors.lastname: Rosas
authors.affiliation: Department of Surgery, Section of Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA.
authors.forename: Homero
authors.initials: H
authors.lastname: Rivas
authors.affiliation: Department of Surgery, Section of Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA.
authors.forename: Dan
authors.initials: D
authors.lastname: Azagury
authors.affiliation: Department of Surgery, Section of Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305, USA. Electronic address: morton@stanford.edu.
authors.forename: John M
authors.initials: JM
authors.lastname: Morton
mesh_terms: D000328:Adult; D017677:Age Distribution; D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods*; D015992:Body Mass Index; D016208:Databases, Factual; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States
keywords: Bariatric surgery; Obesity; Readmissions