Complications After Vertical Sleeve Gastrectomy Linked With Social Determinants of Health

Social determinants of health increase the likelihood patients will develop postoperative complications after undergoing vertical sleeve gastrectomy, according to study results published online ahead of print in Surgery.

“Vertical sleeve gastrectomy is one of the most common bariatric procedures worldwide, but the impact of social determinants of health on postoperative outcomes for this procedure has not been well characterized,” wrote first author Syed I. Khalid, MD, of Rush University Medical Center and coauthors.

To investigate the impact of social determinants of health and postoperative outcomes after vertical sleeve gastrectomy, researchers used the all-payer claims database MARINER-15. Postoperative complications included cardiac complication, acute kidney injury, deep vein thrombosis, wound complication, hematoma, pneumonia, pulmonary embolism, transfusion, or urinary tract infection within 60 days of surgery.

Patients who qualified to be in the “social determinants of health” cohort had an average hospital length of stay of 3.07 days compared with 1.582 days for other patients, according to the study. Patients in the social determinants of health cohort were also more likely to develop any complication within 60 days of surgery; researchers reported a hazard ratio of 1.20.

Nevertheless, patients in the social determinants of health cohort were less likely to return for hospital readmission. The study found hazard ratios of 0.80 for 30-day readmissions and 0.85 for 90-day readmissions for the cohort.

“Although patients with social determinants of health are more likely to develop any of the analyzed postoperative complications within 60 days, they are less likely to return for readmission,” researchers wrote, “highlighting the importance of focused follow-up and other measures to avoid lapses in care and eliminate further barriers to care in this population.”

Reference:
Khalid SI, Maasarani S, Shanker RM, Becerra AZ, Omotosho P, Torquati A. Social determinants of health and their impact on rates of postoperative complications among patients undergoing vertical sleeve gastrectomy [published online ahead of print, 2021 Jul 21]. Surgery. 2021;S0039-6060(21)00618-8. doi:10.1016/j.surg.2021.06.023