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Rates and reasons for emergency department presentations of patients wait-listed for public bariatric surgery in Tasmania, Australia

Kuzminov, A ORCID: 0000-0002-7544-4752, Wilkinson, S, Palmer, AJ ORCID: 0000-0002-9703-7891, Otahal, P ORCID: 0000-0003-4042-1769, Hensher, M ORCID: 0000-0001-6444-6827 and Venn, AJ ORCID: 0000-0001-7090-1398 2019 , 'Rates and reasons for emergency department presentations of patients wait-listed for public bariatric surgery in Tasmania, Australia' , Obesity Research and Clinical Practice, vol. 13, no. 2 , pp. 184-190 , doi: 10.1016/j.orcp.2019.01.002.

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Background: Demand for bariatric surgery in the public hospital setting in Australia is high with prolonged wait-list times. Policy-makers need to consider the consequences of expanding public bariatric surgery including on emergency department (ED) presentations.Aims: To describe and evaluate public ED presentation rates and reasons for presenting in a cohort of patients wait-listed for public surgery.Methods: All Tasmanians placed on the public wait-list for primary bariatric surgery in 2008-2013 were identified using administrative datasets along with their ED presentations in 2000-2014. The presentations were assigned to one of three periods: before wait-list placement, whilst on the wait-list, and after wait-list removal for publicly-funded surgery or drop-out. A negative binomial mixed-effects regression model was used to derive ED presentation incidence rate ratios (IRR) to compare observation periods and patient groups.Results: 652 wait-listed patients had 5149 public ED presentations. 178 patients had publicly-funded bariatric surgery - all as laparoscopically adjustable gastric banding (LAGB). Overall, ED presentation rates did not change significantly post-surgery compared with the waiting period (IRR 1.19, 95%CI 0.90-1.56). Presentation rates significantly increased for digestive system (IRR 2.02, 95%CI 1.19-3.45) and psychiatric diseases (IRR 4.85, 95%CI 1.06-22.26) after surgery. The likelihood of being admitted from the ED significantly increased after surgery (31.7%-38.9%, pConclusion: ED presentations were common for patients wait-listed for public bariatric surgery and rates did not decrease over an average of three years post-LAGB. The likelihood of being admitted to the hospital from the ED increased after surgery.

Item Type: Article
Authors/Creators:Kuzminov, A and Wilkinson, S and Palmer, AJ and Otahal, P and Hensher, M and Venn, AJ
Keywords: bariatric surgery, wait-list, emergency department presentations
Journal or Publication Title: Obesity Research and Clinical Practice
Publisher: Elsevier BV
ISSN: 1871-403X
DOI / ID Number: 10.1016/j.orcp.2019.01.002
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Copyright 2019 Asia Oceania Association for the Study of Obesity

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