THE EFFECT OF MENTAL HEALTH DISORDERS ON POST-OPERATIVE OUTCOMES AFTER BARIATRIC SURGERY
Lin Li*, Maiana Feuerborn, Courtney Barry, Kathleen Lak
Surgery, Medical College of Wisconsin, Milwaukee, WI
Introduction:
Mental health disorders are prevalent amongst patients seeking bariatric surgery. The objective of this study was to determine the impact of mental health disorders on hospital length of stay (LOS), post-operative complications, and 30-day readmission rates after bariatric surgery. Weight loss outcomes to 12 months post-operatively were evaluated as a secondary outcome.
Methods:
Patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) at a single academic institution between January 2014 to June 2018 were retrospectively reviewed. Mental health disorders were identified using pre-operative psychological evaluations and categorized by severity; demographic data and medical history were obtained from the electronic medical record (EMR) in conjunction with data obtained from the MBSAQIP database. Hospital length of stay (LOS), post-operative complications, 30-day readmission rates, and excess weight loss (EWL) were obtained from the EMR and compared between patients with mental health disorders and those without a psychiatric history.
Results:
Of the 578 patients who underwent bariatric surgery in the study period, 69.4% were female and 34.0% underwent LRYGB. Thirty-one percent of patients had a history of a mild mental health disorder and 2% had a history of severe mental health disorder. Eleven percent of patients had an emergency department visit within 30 days of surgery and 2% were readmitted within 30 days. Patients who had a prolonged hospital length of stay (4 or more days duration) had a 43% chance of having mild mental illness. Individuals with a severe mental illness were 7% more likely to have 4 readmissions within 30 days. Individuals with bipolar or other psychosis were 6% more likely to have 1 readmission within 30 days. There was no difference demonstrated between patients with and without mental illness with regards to weight loss outcomes to 12 months.
Conclusion:
Patients with mental health disorders had longer hospital length of stays after bariatric surgery compared to patients without mental health disorders. There was, however, no significant difference in 30-day complications, emergency department visits or readmissions demonstrated in those with and without mental health diagnoses. With increased focus on hospital length of stay after bariatric procedures, additional interventions within this patient population may be warranted.
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