Background

Bariatric surgery leads to many nutritional deficiencies, specifically with calcium absorption and has long-term impacts on bone density. Previous studies explore hyperparathyroidism after Roux-en-Y gastric bypass (RYGB) but there are no studies looking at readmission rates for hyperparathyroidism in patients after either RYGB or sleeve gastrectomy (SG). We sought to assess the frequency of readmission and related comorbidities in this patient population.

Methods

The Nationwide Readmission Database (NRD) from 2010 to 2015 was queried for all patients who had previously underwent bariatric surgery with a readmission diagnosis of hyperparathyroidism. Multivariate logistic regression was used to determine the odds ratios for the outcomes of interest.

Results

There were 915,792 patients who had bariatric surgery. 395,938 (43.2%) had undergone a SG with the remaining having RYGB. In total, 589 bariatric surgery patients were readmitted for hyperparathyroidism. The majority were female (80.8%) and had a CCI ≥2 (68%). Multivariate regression revealed that patients between the age of 45-64(OR 1.42, p=0.001) and those with Medicare(OR 3.01, p<0.001) or Medicaid(OR 2.61, p<0.001) were more likely to be readmitted after bariatric surgery for hyperparathyroidism. Comorbidities associated with the highest ORs for readmission with hyperparathyroidism were renal failure(OR 17.14, p<0.001), hypertension(OR 2.89, p<0.001), and deficiency anemias(OR 2.62, p<0.01).

Conclusions

Readmission rates are frequently used as a quality metrics for patient care. Efforts should be made to reduce readmission for patient groups at higher risk. Bariatric surgery patients with renal failure, hypertension, and anemias should have earlier follow-up with monitoring of calcium, vitamin D, and PTH levels.