Metabolic and bariatric surgery outcomes in patients with gastroparesis: a retrospective analysis of the 2016 to 2022 Nationwide Readmissions Database.

BACKGROUND

A subset of patients undergoing metabolic and bariatric surgery (MBS) for obesity treatment develop gastroparesis. It remains unclear how gastroparesis influences MBS outcomes.

METHODS

This study queried the 2016-2022 Nationwide Readmissions Database for patients aged ≥18 years with obesity who underwent sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB). The primary outcomes were 30-day readmission, 30-day reoperation, length of stay (LOS), and discharge disposition. The secondary outcome was procedure type. This study investigated the unadjusted (using t tests, Kruskal-Wallis tests, and chi-square tests) and adjusted (using logistic regression) associations between gastroparesis status and outcomes.

RESULTS

Of 1,120,048 patients, 5738 (0.51%) had gastroparesis. Patients with gastroparesis were proportionally more likely to undergo RYGB than those without gastroparesis (65.6% vs 30.3%, respectively; P <.001). In addition, compared to patients without gastroparesis, those with gastroparesis had higher readmission rates (3.4% vs 7.7%, respectively; P <.001) and reoperation rates (1.0% vs 2.3%, respectively; P <.001) and were more likely to have longer LOS (median days: 1.0 vs 2.0, respectively; P <.001) and require home health services (1.8% vs 3.1%, respectively; P <.001). After adjusting for sociodemographic and clinical factors, patients with gastroparesis were 63.0% more likely to experience readmission (adjusted odds ratio [aOR], 1.64 [95% CI, 1.36-1.96]), 58.0% more likely to undergo reoperation (aOR, 1.58 [95% CI, 1.12-2.28]), and 75.4% more likely to stay >72 h in the hospital (aOR, 1.75 [95% CI, 1.46-2.11]).

CONCLUSION

MBS patients with gastroparesis more frequently undergo RYGB than the MBS population without gastroparesis. Patients with gastroparesis experience higher readmission and reoperation rates and are more likely to have a longer LOS. MBS teams should consider counseling patients about the risk of these postoperative events.