Is Same-Day Discharge for Gastric Sleeve Surgery Safe?

The 30-day mortality rate associated with same-day discharge following gastric sleeve surgery is 5 times higher than with discharged 1 day after surgery, according to a recent study.¹

Findings from the study were presented at the American Society for Metabolic & Bariatric Surgery (ASMBS) Obesity Week 2017, which is taking place from October 29 to November 2, 2017, in Washington, DC.
___________________________________________________________________________________________

RELATED CONTENT
Benefits of Bariatric Surgery Last Up to 12 Years
Lifestyle Factors Affect Weight Loss Following Bariatric Surgery
___________________________________________________________________________________________

Previous studies have shown that metabolic and bariatric surgery are the most effective and long-lasting treatments for severe obesity and various related conditions, and is associated with significant weight loss. In particular, gastric sleeve surgery is one of the safest and most popular bariatric surgery options in the United States.

For their study, Ninh T. Nguyen, MD, of the University of California, Irvine School of Medicine, and colleagues assessed 37,301 patients who had undergone gastric sleeve procedures, and examined rates of 30-day mortality and complications, as well as rates of readmission and reoperation. Of these patients, 2031 had been discharged on the same day of the surgery, and 35,720 had been discharged 1 day after the surgery.

Patient data were obtained from the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) national database. Mean patient body mass index (BMI) at baseline was 43 kg/m².

Results indicated that the 30-day mortality rate associated with same-day gastric sleeve surgery was 0.10%. According to the researchers, although this rate was low, it was 5-times higher than the mortality rate among patients who had been discharged 1 day after surgery (0.02%, most likely due to respiratory failure).

No statistically significant differences were observed between groups for overall complications (0.98% [same-day] vs 0.86% [1 day later]), reoperations (0.54% vs 0.33%), or readmissions (2.41% vs 2.10%).

“What a difference a day makes,” said Dr Nguyen. “This study cautions that surgeons performing outpatient gastric sleeve surgery should carefully select only low-risk patients for same day discharge, such as patients with no respiratory issues such as obstructive sleep apnea. The higher mortality rate in the same day discharge group is likely related to respiratory failure events that occurred in an unsupervised and unmonitored setting.”²

—Christina Vogt

Reference:

1. Inaba C, Koh CY, Sujatha-Bhaska S, Nguyen N. How safe is same-day discharge for laparoscopic sleeve gastrectomy? (A128). Paper presented at: ASMBS Obesity Week 2017; October 29-November 2, 2017; Washington, DC. http://www.soard.org/article/S1550-7289(17)30443-4/fulltext.

2. New study raises caution over same-day gastric sleeve surgery [press release]. Washington, DC. American Society for Metabolic & Bariatric Surgery. Accessed November 1, 2017.