Background

Background In 2018, North Shore University Hospital was identified in Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) risk-adjusted Semi-Annual Report (SAR) report as “need improvement” in SG serious event with observed rate of 2.29% and re-operative rate of 1.71% in the10th decile. Aim We aim to identify correctable factors in patients with hemorrhage after sleeve gastrectomy and reduce re-operative rate to <1% over the next 3 years.

Methods

175 patients with primary sleeve gastrectomy between January 1, 2021- December 31, 2021 were identified. Relevant comorbidities such as hypertension, diabetes, and obstructive sleep apnea were examined in these patients. Patients with a diagnosis of upper gastrointestinal bleeding, or acute blood loss requiring blood transfusions, returned to operating room, or readmitted within 30 days after discharge were reviewed.

Results

Mean age was 41.5 years and BMI 44.01kg/m2 respectively, with 126 (72%) females and 49 (28%) males. Mean length of stay was 1.4 days. 2.3% (4) of patients were identified with bleeding with a re-operative rate of 1.7% (3). 50% alf of these patients received blood transfusions of two or more units. Two patients transferred to SICU, one patient was a 30-day readmission. Hypertension, diabetes, and OSA identified as risk factors that may have influenced postoperative bleeding. On return to OR, no clear source of bleeding identified.

Conclusions

It is unclear if acute GI bleeding may have been prevented. We planned to use the SLEEVE BLEED Risk Predictive Calculator to optimize clinical decision making to improve postoperative outcomes.