Hospitalization rates increase after gastric-bypass surgery
Caroline Barranco
Original article
Zingmond DS et al. (2005) Hospitalization before and after gastric bypass surgery. JAMA 294: 1918–1924 PubMed
Patients who undergo Roux-en-Y gastric-bypass surgery (RYGB) are more than twice as likely to be hospitalized in the year after their surgery as in the year preceding it, and postsurgical hospitalization is more likely to be for procedure-related complications, a team from California has found.
Between 1995 and 2004, 60,077 California residents underwent RYGB for obesity. Rates of hospitalization for the year preceding and the year following RYGB were 7.9% and 19.3%, respectively (P <0.001). Three-year follow-up data were available for 24,678 patients, 8.4% of whom were hospitalized in the year preceding RYGB, most commonly for obesity-related complications or elective surgeries. In the first, second and third years after RYGB, rates of hospitalization were 20.2%, 18.4% and 14.9%, respectively; in those patients with 5 years of follow-up, hospitalization rates were still raised 5 years after RYGB (13.3%)
Notably, post-RYGB hospitalization in the year following surgery was most commonly for procedure-related complications, but by the third year post-RYGB, most admissions were for elective surgeries, some of which might have been delayed purposefully until the patients had achieved weight-loss targets. Multivariate analysis showed that patients with a higher comorbidity index and those who had previously been hospitalized were more likely to be readmitted within a year of RYGB (P <0.001 for both).
Weaknesses of the study include its retrospective nature and incomplete data on the use of open versus laparoscopic procedures, which did not permit direct comparison of hospitalization rates following these techniques. The likelihood of post-RYGB hospitalization should, however, be a factor in patients' and doctors' treatment decision-making.
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Subject areas under which this article appears: Surgery
