Surg Obes Relat Dis. 2025 Nov 10:S1550-7289(25)01022-6. doi: 10.1016/j.soard.2025.10.016. Online ahead of print.
ABSTRACT
BACKGROUND: Same-day discharge (SDD) in sleeve gastrectomy (SG) is becoming increasingly common but requires careful patient selection.
OBJECTIVES: To evaluate the risk profile of patients undergoing primary SG with SDD and assess 30-day serious adverse events (SAEs) in SDD and next-day discharge (NDD).
SETTING: MBSAQIP 2020-2023 (United States).
METHODS: SDD and NDD patients were categorized as low-risk (LR) [age<65 years, body mass index [BMI] <50 kg/m2, and no history of foregut surgery, diabetes, sleep apnea, cardiovascular disease, kidney disease, immunosuppression or thromboembolic events], and high-risk (HR) [patients with at least one of these conditions]. Logistic regression models assessed odds of SAE (i.e., Comprehensive Complication Index ≥26.2) between SDD and NDD based on risk categories and cumulative number of risk factors (RFs).
RESULTS: Forty thousand three hundred eighty-seven SDDs (50.4% LR, 49.6% HR) and 281,718 NDD (41.2% LR, 58.8% HR) were identified. The odds of HR patients experiencing SAE were higher in the SDD versus NDD (odds ratio [OR]: 1.26, confidence interval [CI]: 1.09-1.45, P < .001). Among high-risk SDD, 66.9% patients had one RF, 25.7% had two and 7.4% had ≥ 3. Compared to patients with a single RF, those with 2 RFs and ≥3RFs were more likely to experience SAEs (OR = 1.40 and 2.10, respectively; P < .01).
CONCLUSIONS: This study demonstrates that 50% of the SDD SG patients were considered high-risk and 32% had multiple RFs. Performing SG with SDD in high-risk patients is associated with a greater likelihood of SAE. Results warrant implementation of risk stratification models to ensure patient safety while maximizing the benefits of SDD.
PMID:41387079 | DOI:10.1016/j.soard.2025.10.016