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. 2025 Jul;39(7):4470-4478.
doi: 10.1007/s00464-025-11799-x. Epub 2025 May 16.

Patient and operative characteristics of readmission and poly-readmission following metabolic surgery: an MBSAQIP analysis (2015-2021)

Michael Kachmar  1   2 , John M Gunaldo  2 , Jake E Doiron  1   2 , Florina Corpodean  1   2 , Denise M Danos  3 , Carlos Galvani  2   4 , Michael W Cook  2   4 , Philip R Schauer  1   2 , Vance L Albaugh  5   6   7
Affiliations

Patient and operative characteristics of readmission and poly-readmission following metabolic surgery: an MBSAQIP analysis (2015-2021)

Michael Kachmar et al. Surg Endosc. 2025 Jul.

Abstract

Background: Recently, same-day Metabolic Surgery (MS) has gained traction, especially to reduce costs and hospital resource utilization. While shorter hospital stays are desirable, accelerated discharge could increase postoperative burden for those patients at risk. This study evaluated whether specific patient characteristics are associated with increased 30-day readmission rates and number of readmissions as a potentially identifying those less suited for same-day discharge.

Methods: Using the MBSAQIP (2015-2021), 960,757 cases of primary minimally invasive sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS) were included. Readmission characteristics were extracted from ancillary Participant Use Files (PUF) and linked to the main MBSAQIP data. Zero-inflated Poisson (ZIP) models assessed associations between preoperative patient characteristics and readmission risk. The two-stage models analyzed odds of any 30-day readmission and calculated the relative risk (RR) of multiple readmissions.

Results: Several key predictors of single as well as multiple readmissions in the first 30 days following intervention were noted. Black or Hispanic race, BMI, diabetes, COPD, GERD, and therapeutic anticoagulation were associated with increased odds of readmission likelihood after MS. Black race and GERD predicted increased readmission frequency (multiple readmissions) among all readmission cases, while those aged ≥ 40 years and Hispanic race were less likely to require multiple readmissions.

Conclusion: This large-scale MS analysis highlights patient characteristics that should be carefully considered by MS providers during patient counseling and consideration of same-day discharge. Readmission poses significant financial, physiological, and psychological burdens emphasizing the need for careful patient evaluation and counseling, particularly for those at higher risk, to optimize patient outcomes in the context of accelerated discharge protocols.

Keywords: Bariatric surgery; MBSAQIP; Metabolic surgery; Multiple readmissions; Postoperative outcomes; Readmission; Risk factors; Roux-en-Y gastric bypass; Same-day discharge (SDD); Sleeve gastrectomy.

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Conflict of interest statement

Declarations. Disclosures: Dr. Michael W. Cook served as a consultant for Asensus Surgical, Intuitive Surgical, and Vicarious Surgical. Dr. Philip R. Schauer reports receiving research grants from Ethicon and Medtronic; receiving personal consulting fees or honoraria from GI Dynamics, Keyron, Persona, Mediflix, Metabolic Health International, LTD, Lilly, Heron, Novo Nordisk, Klens; serving on scientific advisory boards for SE Healthcare Board of Directors, GI Dynamics, Keyron, Persona, Mediflix; and having ownership interest in SE Healthcare LLC, Mediflix, Metabolic Health International, LTD. Dr. Carlos Galvani reports receiving Honoria from Intuitive Surgical and Gore Medical. Dr. Vance L. Albaugh MD reports receiving research grants from Ethicon, as well as consulting fees from Novo Nordisk. Drs. Michael Kachmar, Jake E. Doiron, Florina Corpodean, Denise M. Danos and Mr. John M. Gunaldo have no conflicts of interest or financial ties to disclose.

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