1. In this retrospective cohort study, patients with a history of depression, anxiety, or both did not have a significant increase in emergency department visits following bariatric surgery compared to those without.
2. Furthermore, patients with a history of depression and/or anxiety also did not have an increase in hospital readmissions in the first year post-bariatric surgery compared to those without.
Evidence Rating Level: 2 (Good)
Patients who undergo bariatric surgery have a high prevalence of preoperative mental illness. Although patients with bipolar disorder and schizophrenia experience more emergency department (ED) visits following bariatric surgery, it is unclear if this relationship exists in bariatric surgery patients with other mental health disorders. This study aimed to assess whether patients with a history of anxiety and/or depression experience more ED encounters and hospital readmissions following bariatric surgery than those without either illness at an institution with a robust preoperative multidisciplinary program.
The study included 1,113 patients who underwent bariatric surgery between March 2012 and December 2019. Patients were included if they had undergone a sleeve gastrectomy or gastric bypass during the study period. Information on depression, anxiety, patient demographics, ED encounters, and hospital readmissions was obtained from a review of electronic medical records. The multidisciplinary program includes weekly meetings between surgeons and psychologists to evaluate patient readiness for surgery and provide necessary treatment for mental illnesses. The primary outcome was the difference in ED encounters and hospital readmissions between those with and without depression and/or anxiety.
The results demonstrated that patients with a history of depression and/or anxiety did not have a significant increase in ED visits nor hospital readmissions in the first year following bariatric surgery compared to those who did not have either disorder. Furthermore, those who received sleeve gastrectomy experienced fewer ED visits and hospital readmissions compared to other bariatric surgeries. However, the study was limited by the confounding factor of the preoperative multidisciplinary program, which limits the generalizability of these findings to other bariatric surgery patients with anxiety and/or depression. Nonetheless, this study provided evidence to suggest that patients with anxiety and/or depression do not experience higher rates of readmission and ED visits following bariatric surgery than those without.
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