National Trends in Bariatric Surgery 2012–2015: Demographics, Procedure Selection, Readmissions, and Cost

• Published in: Obesity surgery 2017-11, Vol.27 (11), p.2933-2939
• Main Authors: Kizy, Scott, Jahansouz, Cyrus, Downey, Michael C., Hevelone, Nathanael, Ikramuddin, Sayeed, Leslie, Daniel
• Format: Article
• Language: English
• Subjects: Adult; Bariatric Surgery - adverse effects; Bariatric Surgery - economics; Bariatric Surgery - methods; Bariatric Surgery - trends; Choice Behavior; Databases, Factual; Demographics; Diabetes; Diabetes Mellitus, Type 2 - economics; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - surgery; Female; Gastrectomy - adverse effects; Gastrectomy - economics; Gastrectomy - methods; Gastrectomy - trends; Gastric Bypass - adverse effects; Gastric Bypass - economics; Gastric Bypass - methods; Gastric Bypass - trends; Gastrointestinal surgery; Health Care Costs - statistics & numerical data; Health Care Costs - trends; Health care expenditures; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity, Morbid - economics; Obesity, Morbid - epidemiology; Obesity, Morbid - surgery; Original Contributions; Patient Readmission - economics; Patient Readmission - statistics & numerical data; Patient Selection; Surgery; Surgical outcomes; Surgical techniques; United States - epidemiology; Weight control
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-017-2719-1

Background Bariatric surgery is widely accepted as the best treatment for obesity and type 2 diabetes mellitus (T2DM). The Roux-en-Y gastric bypass (RYGB) and the sleeve gastrectomy (SG) have become the predominant bariatric procedures in the USA over the last several years, although the most recent trends in selection are unknown. Objective The objective of this study is to assess selection trends, readmission rates, and cost of bariatric procedures in the USA from 2012 to 2015. Methods We used the Premier database from 2012 to 2015 to examine trends in incidence of RYGB, adjustable gastric banding (LAGB), and SG; readmissions; and cost. Multivariate regression was performed to identify predictors of readmission. Results The proportion of SG went up from 38 to 63% while the RYGB decreased from 44 to 30% over this time period. LAGB has decreased in use from 13 to 2%. In comparison to RYGB, readmission was less likely for SG (OR 0.64), males (OR 0.91), and more likely for black race (OR 1.27). The overall proportion of patients seeking RYGB with type 2 diabetes was higher than with SG (36 versus 25%), but SG has now overtaken RYGB as the most common procedure among diabetics. The SG is less costly than RYGB ($11,183 versus $13,485). Conclusions There is a continued overall trend in the increased popularity of the SG and decreased utilization of the RYGB and LAGB, although growth of the SG appears to be slowing. This is also true among patients with type 2 diabetes mellitus. Regardless of surgery type, underinsured and African-American race were more likely to be readmitted.