Background

30-day follow-up is a crucial component of quality improvement initiatives that aim to advance patient outcomes. The MBSAQIP database has allowed us to further investigate characteristics of patients demonstrating better adherence to follow-up.

Methods

We used the MBSAQIP national registry from 2015-2019 to identify characteristics that predict better adherence to 30-day follow-up after metabolic and bariatric surgery. The patient cohort included those who underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Analysis excluded those with emergent surgery, ASA class 5, and those with conditions present at the time of surgery.

Results

There is no clinically significant difference in 30-day follow-up between RYGB and SG, (95.9% vs. 95.2%, p<0.001) and between robotic and laparoscopic approach (95.4% vs. 95.4%, p=0.8). There is no difference between females and males (95.4% vs. 95.3%, p=0.5). Rates of 30-day follow-up improved with age, particularly in those >70 years old (97% vs. 95.3%, p<0.001). Slight differences were noted in patients who underwent additional procedures by a second provider and those who experienced severe adverse events. Patients who were discharged home had higher follow-up rates relative to those who did not (95.4% versus 91.1%; p<0.001).

Conclusions

Approximately 5% of all patients undergoing metabolic and bariatric surgery are lost to follow-up at 30-days. We noted slight differences in follow-up rates based on age, procedure type, discharge destination, and occurrence of severe adverse events following the index procedure. These results could help us identify groups for whom increased effort to maintain follow-up contact may be warranted.