Patients have increased hospitalization rate after gastric bypass surgery

Patients who have gastric bypass surgery have double the rate of hospitalization in the year following the operation than in the year preceding surgery, according to a study in the October 19 issue of JAMA.

Bariatric surgical procedures are an increasingly common treatment for morbid obesity, according to background information in the article. More than 100,000 Roux-en-Y gastric bypasses (RYGB)--the primary bariatric procedure now done--are performed annually in the United States. A recent systematic review and meta-analysis of bariatric procedures determined that the average percentage of excess weight loss after operation was 61 percent, with rates of resolution or improvement for the following co-existing illnesses: diabetes 86 percent, hyperlipidemia 70 percent, hypertension 79 percent, and obstructive sleep apnea 84 percent. Utilization of inpatient services after RYGB is not well understood.

David S. Zingmond, M.D., Ph.D., of the University of California, Los Angeles, and colleagues assessed the impact of RYGB on use of inpatient care by examining rates of inpatient hospitalization before and after RYGB performed in California between 1995 and 2004.

In California from 1995-2004, a total of 60,077 California residents underwent RYGB for obesity, with 11,659 in 2004. The average age was 42.2 years, 84 percent of patients were women, and 88 percent were privately insured or self-pay. Average length of stay was 3.5 days. For patients with a year of follow-up (1995-2003), 19.3 percent were readmitted within the first year after RYGB surgery compared with 7.9 percent being admitted in the year before surgery. In a subset analysis of all patients (24,678) who underwent RYGB with complete 3-year follow-up, the average percentage of patients admitted in the year prior to RYGB was 8.4 percent. In each of the 3 years following RYGB, the rates of hospitalization remained increased, with 20.2 percent of patients readmitted in the first year after

Contact: Rachel Champeau
JAMA and Archives Journals

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