Where are sleeves performed? An analysis of inpatient versus outpatient databases in a large state

Abstract

Background: The sleeve gastrectomy (SG) is the most common bariatric surgery in the United States today. There is a trend toward performing SG as an outpatient procedure, either in an ambulatory setting or as an outpatient at a larger hospital. The term "outpatient" is used to designate essentially any patient without an inpatient order. Texas maintains the Texas Inpatient Public Use Data File (IPUDF) database and the Texas Outpatient Public Use Data File (OPUDF) database for inpatient and outpatient settings, respectively.

Objectives: To determine where SGs are performed by evaluating the Texas IPUDF and OPUDF for 2016.

Setting: University hospital, United States.

Methods: The Texas IPUDF and OPUDF were searched with the Current Procedural Terminology code of 43775 and the International Classification of Diseases, 10^th revision, procedure code of 0DB64Z3. Patient demographic characteristics were also examined. We looked at the top 5 diagnoses in each database.

Results: Of the 16,855 SGs performed in Texas in 2016, outpatient SGs accounted for 31.0% (5227 cases), and inpatient SGs accounted for 69% of the total with 11,628 cases reported. For patients reported in the OPUDF, mean length of stay (LOS) was 2.1 (standard deviation 3.2) days with a median of 1.0 (interquartile range = 1, 2) days; for patients in the IPUDF, mean LOS was 1.6 (standard deviation 1.5) days, and the median was 1.0 (interquartile range = 1, 1) days.

Conclusion: A third of SGs in Texas were performed under outpatient status. Further study is needed to determine the safety of this practice.

Keywords: Administrative databases; Ambulatory surgery; Outpatient surgery; Sleeve gastrectomy.