Background

The COVID pandemic led to significant strain on health care resources causing an exponential rise in the rate of same day discharge after sleeve gastrectomy (SDSG). The goal of this study was to determine if there was an increase in adverse outcomes to SDSG during COVID years (2020-2021) as compared to pre-COVID years (2015-2019).

Methods

A retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Project (MBSAQIP) from 2015-2021 was performed. Univariate analysis was performed comparing demographics, comorbid disease and risk of adverse events within 30 days of SG by postoperative discharge day separated into pre-COVID and COVID years (2015-2019 vs 2020-2021).

Results

A total of 702,622 SGs were performed during the study period. 31,394 (4.51%) of patients were SDSGs. 14,446 SDSG were performed pre-COVID while 16,862 during COVID. There were statistically significant adverse outcomes in pre-COVID SDSG including any complications (1.3% vs 1%, p<0.001), minor complications (1% vs 0.8%, p 0.003), readmission (2.8% vs. 2.2%, p<0.0001), reoperation (0.6% vs. 0.5%, p 0.001), and intervention (0.7% vs. 0.5% p 0.003) compared to those discharged on POD1. However, during COVID, the only statistically significant adverse outcome when comparing SDSG and POD1 patients was readmission (1.5% vs. 1.8%, p<0.001).

Conclusions

When compared to patients discharged on POD1, SDSG were at significantly increased risk for all adverse outcomes during the pre-COVID years. Despite significantly increased rates of SDSG during COVID, clinicians select lower risk patients for SD discharge. We demonstrate the importance of patient selection when considering SDSG.