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Observational Study
. 2023 Dec;93(12):2833-2842.
doi: 10.1111/ans.18575. Epub 2023 Jun 20.

The length of hospital stay following bariatric surgery in Australia: the impact of patient, procedure, system and surgeon

Chiara Chadwick  1   2 , Paul R Burton  1   2 , Dianne Brown  3 , Jennifer F Holland  3 , Angus Campbell  3 , Jenifer Cottrell  3 , Jennifer Reilly  1   4 , Andrew D MacCormick  3   5 , Ian Caterson  6   7 , Wendy A Brown  1   2   3
Affiliations
Observational Study

The length of hospital stay following bariatric surgery in Australia: the impact of patient, procedure, system and surgeon

Chiara Chadwick et al. ANZ J Surg. 2023 Dec.

Abstract

Background: The length of a patient's stay (LOS) in a hospital is one metric used to compare the quality of care, as a longer LOS may flag higher complication rates or less efficient processes. A meaningful comparison of LOS can only occur if the expected average length of stay (ALOS) is defined first. This study aimed to define the expected ALOS of primary and conversion bariatric surgery in Australia and to quantify the effect of patient, procedure, system, and surgeon factors on ALOS.

Methods: This was a retrospective observational study of prospectively maintained data from the Bariatric Surgery Registry of 63 604 bariatric procedures performed in Australia. The primary outcome measure was the expected ALOS for primary and conversion bariatric procedures. The secondary outcome measures quantified the change in ALOS for bariatric surgery resulting from patient, procedure, hospital, and surgeon factors.

Results: Uncomplicated primary bariatric surgery had an ALOS (SD) of 2.30 (1.31) days, whereas conversion procedures had an ALOS (SD) of 2.71 (2.75) days yielding a mean difference (SEM) in ALOS of 0.41 (0.05) days, P < 0.001. The occurrence of any defined adverse event extended the ALOS of primary and conversion procedures by 1.14 days (CI 95% 1.04-1.25), P < 0.001 and 2.33 days (CI 95% 1.54-3.11), P < 0.001, respectively. Older age, diabetes, rural home address, surgeon operating volume and hospital case volume increased the ALOS following bariatric surgery.

Conclusions: Our findings have defined Australia's expected ALOS following bariatric surgery. Increased patient age, diabetes, rural living, procedural complications and surgeon and hospital case volume exerted a small but significant increase in ALOS.

Study type: Retrospective observational study of prospectively collected data.

Keywords: bariatric surgery; efficiency; obesity; outcomes; safety.

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Conflict of interest statement

Chiara Chadwick: This research was supported by an Australian Government Research Training Program (RTP) Scholarship. Paul R. Burton: None declared. Dianne Brown: None declared. Jennifer F. Holland: None declared. Angus Campbell: None declared. Jenifer Cottrell: None declared. Jennifer Reilly: None declared. Andrew D. MacCormick: None declared. Ian Caterson: Grants for clinical trials from Boehringer Ingelheim, Eli Lilly, and Sydney Local Health Districts. Currently, serves on the advisory board of InsideOut (for eating disorders), the board of Obesity Australia, and chairs the Executive Management Committee of the Australian and New Zealand Bariatric Surgical Register. He was past president of the World Obesity Federation. Wendy A. Brown: Grants from Johnson and Johnson, Medtronic, GORE, Applied Medical, and the Australian Commonwealth Government for the ANZ Bariatric Surgery Registry. Additional grant funding from Novo Nordisc, NHMRC, Myerton, Personal fees from GORE, Novo Nordisc, Pfizer and Merck Sharpe and Dohme for lectures and advisory boards.

Figures

Fig. 1
Fig. 1
Cohort selection.
Fig. 2
Fig. 2
Data distribution—all procedures.
Fig. 3
Fig. 3
Mean (CI95%) LOS (days) per year of operation (a) primary procedures and (b) conversion procedures.
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References

    1. Australian Institute of Health and Welfare 2017 . Weight loss surgery in Australia 2014–15: Australian hospital statistics. Cat. no. HSE 186. Canberra: AIHW.
    1. Backman B, Brown D, Cottrell J, et al. The Bariatric Surgery Registry Annual Report, 2015. Monash University, Department of Epidemiology and Preventive Medicine, August. 2015.
    1. Backman B, Brown D, Cottrell J, et al. The Bariatric Surgery Registry Annual Report, 2019. Monash University, Department of Epidemiology and Preventive Medicine, August. 2019.
    1. Metabolic and bariatric surgery fact sheet: ASMBS [American Society for Metabolic and Bariatric Surgery website], August 6. 2021. [Cited 11 Nov 2022.] Available from URL: https://asmbs.org/resources/metabolic-and-bariatric-surgery.
    1. Brown WA, Ahern S, MacCormick AD, Reilly JR, Smith JA, Watters DA. Clinical quality registries: urgent reform is required to enable best practice and best care. ANZ J. Surg. 2022; 92: 23–6. 10.1111/ans.17438. - DOI - PubMed

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