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

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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