Preoperative and Intraoperative Factors That Influence Length of Stay in Patients on an Enhanced Recovery after Surgery Protocol following Bariatric Surgery

Arturo Garcia, Marcoandrea Giorgi, Sahil Parikh, Aaron Carr, Mohamed R. Ali

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Enhanced recovery after surgery (ERAS) protocols have gained consensus in laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical sleeve gastrectomy (LSG) operations. We implemented ERAS protocols for bariatric surgery to consider discharge as early as the first postoperative day 1 (POD1). Objectives: To identify the feasibility of early discharge as well as predictors of prolonged hospitalization following bariatric surgery. Methods: Patients who underwent primary LRYGB or LSG between 2010 and 2015 were included. Prospectively collected data included demographic and anthropomorphic measurements, preoperative comorbidities, intraoperative findings, and hospital stay. Univariate and multivariate analyses were used to identify predictors of hospital stay. Results: For LSG, body mass index (BMI) greater than 50 kg/m2 was associated with prolonged hospitalization. Different variables were identified on univariate analysis to be significantly associated with increased hospitalization for LRYGB. On multivariate analysis, insulin-dependent diabetes, decreased functional status, and additional procedures performed with the index case were significant predictors of hospitalization beyond POD1 following LRYGB. BMI was not associated with longer hospitalization after LRYGB. Conclusions: Several factors correlate to extended hospitalization in patients undergoing bariatric surgery. Ultimately, a balance between care based on ERAS principles and the judgment of the surgeon is needed to safely manage these patients.

Original languageEnglish (US)
Pages (from-to)10-14
Number of pages5
JournalBariatric Surgical Patient Care
Volume16
Issue number1
DOIs
StatePublished - Mar 2021

Keywords

  • bariatric surgery
  • discharge
  • eras
  • gastric bypass
  • pre operative factors
  • sleeve gastrectomy

ASJC Scopus subject areas

  • Surgery
  • Nutrition and Dietetics
  • Medical–Surgical

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