Background

Postoperative Emergency Department (ED) utilization is generally poorly understood but known to be a significant source of financial burden in the current healthcare system. Often, these ED visits are for concerns that could be addressed in a different, less overburdened setting. Following bariatric surgery, one of the most common reasons for ED presentation is dehydration. There is limited literature analyzing costs associated with post-bariatric dehydration.

Methods

A retrospective review of a prospectively maintained database was conducted for all patients within a single healthcare system who underwent bariatric surgery between January 2018 and November 2019. Patients who presented to the ED or an outpatient infusion center for IV fluids within 30 days of surgery were included in the study. A cost analysis was conducted comparing overall cost of ED versus hydration visits.

Results

There were 4703 primary bariatric surgeries procedures performed with 476 ED presentations. Average cost per ED visit was found to be $842 (median $548, IQR $2972). Overall, ED visits for IVF hydration were associated with a higher mean cost than outpatient infusion center visits. Additionally, the majority of patients who presented to the ED with dehydration did not require admission.

Conclusions

While ED visits for IVF following bariatric surgery are common, analysis of the associated costs is limited. Our study supports the hypothesis that patients who present with dehydration following bariatric surgery are likely better served in an outpatient setting, where the cost of treatment, impact on resources, and inconvenience to the patient are significantly reduced as compared to the ED.