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Readmissions after Bariatric Surgery

Readmission after bariatric surgery occurs in about 5% of cases and increases the average costs up to 2.5-fold. Risk factors for readmission are dependent functional status, diabetes mellitus, steroid or immunosuppressant use, cardiac disease with intervention, bleeding disorders, longer operative time, concurrent splenectomy, high preoperative creatinine, low serum albumin, and occurrence of postoperative complications during index admission. The most common reasons for readmissions are procedure-related complications, including dehydration, abdominal pain, bleeding, anastomotic leak, gastrointestinal obstruction, and thromboembolic events. Measures that decrease readmissions after bariatric surgery include: effective preoperative education, thorough evaluation before discharge, appropriate discharge instruction with required medications, reasonable discharge disposition, 24-hour phone support, active follow-up of high-risk patients, walk-in clinic, hydration clinic, and training of other hospital teams to manage common complaints after bariatric surgery.