Conference Coverage

GERD, Insurance Status Linked to Longer Hospital Stay After Sleeve Gastrectomy

Anthony Calabro, MA

Key Highlights

  • Gastroesophageal reflux disease was significantly associated with longer hospital stays
  • Female patients reported higher postoperative pain rates
  • Patients with Medicaid experienced longer lengths of stay than those with Medicare or private insurance
  • Researchers did not find a correlation between BMI or additional procedures and length of stay

Among patients undergoing laparoscopic sleeve gastrectomy (LSG), the presence of gastroesophageal reflux disease (GERD), female sex, and Medicaid insurance were associated with a longer postoperative length of stay (LOS), while BMI and additional procedures did not appear to influence LOS in a study presented at the 2025 American Society for Metabolic and Bariatric Surgery Annual Meeting in Washington, D.C.

Understanding contributors to extended hospitalization after LSG is critical for improving perioperative care and optimizing resource utilization. This study addresses the clinical and demographic factors that may prolong hospital stay following bariatric surgery.

Researchers conducted a retrospective analysis using the MBSAQIP database, examining patients who underwent LSG from 2022 to 2023 with a LOS of 2 to 4 days. A total of 78 patients met the inclusion criteria, and 34 completed follow-up phone surveys. Investigators assessed correlations between LOS and various factors, including comorbidities, demographics, and type of insurance.

The results revealed that GERD was a significant contributor to increased LOS. Patients with GERD had LOS values between 2.5 and 3 days, compared to 2.14 to 2.38 days in those with similar comorbidity profiles but without GERD. Female patients were more likely to report pain as a factor influencing longer stays, with 29% citing pain versus 3% of male patients. Insurance status also played a role: Medicaid patients had a longer average LOS (2.24 days) than those with private insurance or Medicare (2.0 days). No significant relationship was identified between LOS and BMI, nor between LOS and additional surgical procedures such as hiatal hernia repair or cholecystectomy.

“A direct correlation was identified between those with GERD and increased LOS,” the authors concluded.

Reference
Ishtiaq A, Barkan A, Bivona A, Sen A, Bahay A, Markovic O. Factors influencing postoperative length of stay after a laparoscopic sleeve gastrectomy. Presented at: ASMBS Annual Meeting; June 2025; Washington, DC. Accessed June 12, 2025. https://www.asmbsmeeting.com/event/2025/welcome