Safety of Same-Day Discharge after Sleeve Gastrectomy in Adults 65 Years and Older

Document Type

Conference Proceeding

Publication Date

11-1-2024

Publication Title

J Am Coll Surg

Keywords

infusion fluid, acute kidney failure, adult, aged, chronic obstructive lung disease, comorbidity, complication, conference abstract, controlled study, dehydration, drug therapy, female, human, hypertension, major clinical study, male, middle aged, obesity, obstructive sleep apnea, retrospective study, sleeve gastrectomy, special situation for pharmacovigilance, surgery, wound dehiscence

Abstract

Introduction: The purpose of this study was to compare outcomes between same-day vs next-day discharge after undergoing minimally invasive sleeve gastrectomy (SG) in adults 65 years and older. Methods: This study was a retrospective analysis of patients 65 years and older discharged on postoperative day (POD) 0 vs POD 1 after undergoing SG in 2022. Data was received from MBSAQIP. Univariate analyses were performed to compare demographics, comorbidity, and 30-day outcomes between patients discharged on POD 0 and 1. Data is presented as frequency and mean ± SD with significance determined by a t-test with p < 0.05. Results: A total of 4,609 patients were included in the study. Of these, 310 (6.7%) were discharged on POD 0 and 4,299 (93%) on POD 1 after SG. POD 0 patients were of similar age, more likely women, and had a lower BMI compared with POD 1 patients (41.4 ± 6.5 vs 42.6 ± 6.4 kg/m2, p = 0.039). Despite a significantly lower rate of hypertension, obstructive sleep apnea, and chronic obstructive pulmonary disease in POD 0 patients, they were more likely to experience wound disruption (p < 0.001), acute renal failure requiring dialysis (p = 0.015), and administration of outpatient intravenous fluids (p = 0.008) (Table 1). Conclusion: Same-day discharge SG for patients 65 years and older is associated with increased 30-day complication rate despite fewer preoperative obesity-associated comorbidities. Older patients may be more sensitive to dehydration events, and consideration should be given to continue inpatient monitoring after SG for these patients.

Volume

239

Issue

5

First Page

S32

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