Earlier today, Stanford surgeon John Morton, MD, presented results of a study showing the potential dangers of outpatient bariatric surgery. Morton and his colleagues reviewed the outcomes of nearly 52,000 patients and found that those discharged on the same day of surgery were 13 times more likely to die than patients who left after two days. Patients who were discharged less than 24 hours after an overnight stay were two times more likely to die. The overall mortality rate for patients who stayed in the hospital for two or more days was 0.1 percent.
I just spoke with Morton, who told me he believes the low mortality rate - which is equivalent to that for hip replacement and gull bladder surgery - may be prompting providers to "push the envelope and send people home the same day." Some may also be influenced by a recent update to the Milliman Care Guidelines - used by many hospitals and health plans to guide care decisions - which called for shortening the length of stay for gastric bypass patients. The American Society for Metabolic & Bariatric Surgery expressed concern (.pdf) with the guidelines last year.
Based on this work, Morton said, early discharge should be approached with caution. And, he told me, "It should be determined by the physician and patient, not the health care insurer."
Morton hopes to publish results of the study later this year.