GERD Is Associated with Higher Long-Term Reoperation Rates After Bariatric Surgery

Tammam Obeid, Aravind Krishnan, Gamal Abdalla, Michael A Schweitzer, Thomas Magnuson, Kimberley Steele

Research output: Contribution to journalArticle

Abstract

Background: Although bariatric surgery is a safe and effective treatment for morbid obesity, long-term reoperation remains a significant source of morbidity and mortality for the patient. Methods: We performed a retrospective analysis of all patients undergoing laparoscopic gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG) surgeries at our institution between 2009 and 2013. Main outcome of interest was reoperation rate up to current date. Final logistic regression model included age, gender, BMI at time of operation, race (Caucasian vs African American), surgery time, length of stay, history of diabetes, history of gastroesophageal reflux disease (GERD), type of surgery, and readmission. Results: A total of 533 patients underwent either LGBP or LSG surgery between 2009 and 2013. Overall reoperation rate was 9.0 % and mean follow-up was 43.9 months (median 45). When stratified by race, preoperative GERD in Caucasians was associated with a significant 2.2-fold increased risk of reoperation (OR 2.2, 95% CI 1.0–4.8, P =.043). GERD in African Americans had a small nonsignificant increased risk. Other significant predictors included length of stay and readmission (OR 2.1, P = 0.029; OR 5.0, P <0.000). Conclusion: Preoperative GERD in Caucasian bariatric patients is associated with a higher risk of reoperation. Lengthy hospital stay and readmission within 30 days of laparoscopic bariatric surgery are independent predictors of higher reoperation rates.

Original languageEnglish (US)
Pages (from-to)119-124
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Bariatric Surgery
Gastroesophageal Reflux
Reoperation
Length of Stay
Gastric Bypass
Gastrectomy
African Americans
Logistic Models
Bariatrics
Patient Readmission
Morbid Obesity
Laparoscopy
Morbidity
Mortality

Keywords

  • Bariatric surgery
  • Gastroesophageal reflux disease
  • GERD
  • Racial disparity
  • Reoperation
  • Roux-en-Y bypass
  • Sleeve gastrectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

GERD Is Associated with Higher Long-Term Reoperation Rates After Bariatric Surgery. / Obeid, Tammam; Krishnan, Aravind; Abdalla, Gamal; Schweitzer, Michael A; Magnuson, Thomas; Steele, Kimberley.

In: Journal of Gastrointestinal Surgery, Vol. 20, No. 1, 01.01.2016, p. 119-124.

Research output: Contribution to journalArticle

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N2 - Background: Although bariatric surgery is a safe and effective treatment for morbid obesity, long-term reoperation remains a significant source of morbidity and mortality for the patient. Methods: We performed a retrospective analysis of all patients undergoing laparoscopic gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG) surgeries at our institution between 2009 and 2013. Main outcome of interest was reoperation rate up to current date. Final logistic regression model included age, gender, BMI at time of operation, race (Caucasian vs African American), surgery time, length of stay, history of diabetes, history of gastroesophageal reflux disease (GERD), type of surgery, and readmission. Results: A total of 533 patients underwent either LGBP or LSG surgery between 2009 and 2013. Overall reoperation rate was 9.0 % and mean follow-up was 43.9 months (median 45). When stratified by race, preoperative GERD in Caucasians was associated with a significant 2.2-fold increased risk of reoperation (OR 2.2, 95% CI 1.0–4.8, P =.043). GERD in African Americans had a small nonsignificant increased risk. Other significant predictors included length of stay and readmission (OR 2.1, P = 0.029; OR 5.0, P <0.000). Conclusion: Preoperative GERD in Caucasian bariatric patients is associated with a higher risk of reoperation. Lengthy hospital stay and readmission within 30 days of laparoscopic bariatric surgery are independent predictors of higher reoperation rates.

AB - Background: Although bariatric surgery is a safe and effective treatment for morbid obesity, long-term reoperation remains a significant source of morbidity and mortality for the patient. Methods: We performed a retrospective analysis of all patients undergoing laparoscopic gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG) surgeries at our institution between 2009 and 2013. Main outcome of interest was reoperation rate up to current date. Final logistic regression model included age, gender, BMI at time of operation, race (Caucasian vs African American), surgery time, length of stay, history of diabetes, history of gastroesophageal reflux disease (GERD), type of surgery, and readmission. Results: A total of 533 patients underwent either LGBP or LSG surgery between 2009 and 2013. Overall reoperation rate was 9.0 % and mean follow-up was 43.9 months (median 45). When stratified by race, preoperative GERD in Caucasians was associated with a significant 2.2-fold increased risk of reoperation (OR 2.2, 95% CI 1.0–4.8, P =.043). GERD in African Americans had a small nonsignificant increased risk. Other significant predictors included length of stay and readmission (OR 2.1, P = 0.029; OR 5.0, P <0.000). Conclusion: Preoperative GERD in Caucasian bariatric patients is associated with a higher risk of reoperation. Lengthy hospital stay and readmission within 30 days of laparoscopic bariatric surgery are independent predictors of higher reoperation rates.

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