Gastroesophageal Reflux Predicts Utilization of Dehydration Treatments After Bariatric Surgery.

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2021-02

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Abstract

Background

Dehydration treatments (DT) provide intravenous fluids to patients in the outpatient setting; however, the utilization of DT is not well-described. We characterize the cohort receiving DT, the first year it was recorded in a bariatric-specific database.

Setting

A retrospective cohort analysis of patients undergoing bariatric surgery between January 1, 2016, and December 31, 2016, in 791 centers in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data file.

Methods

Patients ≥ 18 years with a body mass index (BMI) ≥ 35 kg/m2 who underwent laparoscopic adjustable gastric band (LAGB), sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (LRYGB), and biliopancreatic diversion with duodenal switch (LBPD/DS) were identified. Unadjusted and adjusted rates of DT were analyzed. In addition, adjusted rates and indication for readmission were reviewed.

Results

The overall rate of dehydration treatments was 3.5% for the 141,748 bariatric surgery cases identified. Patient comorbidities of gastroesophageal reflux (GERD) (odds ratio (OR) 1.49; 95% CI, 1.40-1.59), insulin-dependent diabetes (OR = 1.19; 95% CI, 1.07-1.33), and LRYGB (OR = 1.45; 95% CI, 1.36-1.54) were associated with higher odds of DT. DT only had the highest odds of readmission (OR = 6.22; 95% CI, 5.55-6.98) compared to other outpatient visits. Nausea and vomiting, or fluid, electrolyte, or nutritional depletion was the most common indication for readmission in all groups.

Conclusions

Patients with GERD utilized dehydration treatments after bariatric surgery. DT was highly associated with readmissions, and a better understanding of the clinical application of DT will allow bariatric centers to develop programs to further optimize outpatient treatments.

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Journal article

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Bariatric surgery, Dehydration treatments, Diabetes, Duodenal switch, Gastric bypass, Gastroesophageal reflux, Outpatient visits, Readmission

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https://hdl.handle.net/10161/22504

Published Version (Please cite this version)

10.1007/s11695-020-05043-9

Publication Info

Seymour, Keri A, Megan C Turner, Maragatha Kuchibhatla and Ranjan Sudan (2021). Gastroesophageal Reflux Predicts Utilization of Dehydration Treatments After Bariatric Surgery. Obesity surgery, 31(2). pp. 838–846. 10.1007/s11695-020-05043-9 Retrieved from https://hdl.handle.net/10161/22504.

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Scholars@Duke

Seymour

Keri Anne Seymour

Associate Professor of Surgery
Kuchibhatla

Maragatha Kuchibhatla

Professor of Biostatistics & Bioinformatics

Statistical research methodology, analysis of repeated measurements, latent growth curve models, latent class growth models, classification and regression trees,
designing clinical trials, designing clinical trials in psychiatry -- both treatment and non-treatment
trials in various comorbid populations.

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