title: Early discharge in the bariatric population does not increase post-discharge resource utilization.
abstract: There is a trend toward shorter-stay bariatric surgery. However, reducing LOS may increase complications and post-discharge resource utilization. Our goal was to compare outcomes before and after implementation of short-stay bariatric surgery.
  
  
  
  A retrospective chart review of a single-surgeon series of laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB). The two cohorts "target discharge POD 1" and "target discharge POD 2" were analyzed for on time discharges (feasibility) and complications. Patients who were successfully discharged in each cohort were further analyzed for post-discharge resource utilization.
  
  
  
  Early discharge was initiated in November of 2014 with 107 patients identified in this group. An additional 107 patients from those immediately preceding represented the target DC POD 2 group. The target DC POD 2 patients had a significantly higher percentage of patients who met their target LOS. The SD group (overall and LRYGB) had a significantly higher rate of hospital readmissions; this was the only significant difference in primary outcomes between the two groups. There was no difference in mortality, leaks or reoperation.
  
  
  
  This study suggests that short-stay bariatric surgery is feasible and safe. Reducing the LOS from 2 to 1 day did not significantly increase the rate of hospital readmissions, ED visits or patient calls to our office. Further research is necessary to determine whether LOS can be further abbreviated to allow outpatient LSG and LRYGB.
authors.affiliation: Division of Bariatric and Metabolic Surgery, Carolinas HealthCare System, 2608 East 7th Street, Charlotte, NC, 28204, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Rickey
authors.affiliation: Division of Bariatric and Metabolic Surgery, Carolinas HealthCare System, 2608 East 7th Street, Charlotte, NC, 28204, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Gersin
authors.affiliation: Division of Bariatric and Metabolic Surgery, Carolinas HealthCare System, 2608 East 7th Street, Charlotte, NC, 28204, USA.
authors.forename: Wayne
authors.initials: W
authors.lastname: Yang
authors.affiliation: Division of Bariatric and Metabolic Surgery, Carolinas HealthCare System, 2608 East 7th Street, Charlotte, NC, 28204, USA.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Stefanidis
authors.affiliation: Division of Bariatric and Metabolic Surgery, Carolinas HealthCare System, 2608 East 7th Street, Charlotte, NC, 28204, USA. Timothy.Kuwada@carolinashealthcare.org.
authors.forename: Timothy
authors.initials: T
authors.lastname: Kuwada
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Bariatric surgery; Early discharge; Enhanced recovery after surgery (ERAS); Gastric bypass; Short stay surgery; Sleeve gastrectomy