Introduction: Gastric band placement can predispose to infections including intra-abdominal or port-site infections. Limited epidemiological data exists regarding infections due to gastric band procedure including the number of annual hospitalizations, demographic variation, cost of care, comorbidity measures, and outcomes for hospitalizations with infections due to gastric band procedure.
Methods: We analyzed the National Inpatient Sample (NIS) database for all hospitalizations with Infections due to gastric band procedure (ICD-9 code 539.01 and ICD-10 code K95.01 as applicable) as primary or secondary diagnosis during the period from 2012-2018. NIS is the largest all-payer inpatient care database in the United States. Statistical significance of variation in the number of hospitalizations, demographic disparity, cost of care, comorbidity measures, and outcomes during the study period were determined using Cochran-Armitage trend test.
Results: Between 2012 and 2018, the number of hospitalizations ranged from 760 to 380 (p=0.16, figure 1A). Hospitalizations were found to be more common in women (p=0.004) and Caucasians (p< 0.0001). Although age group 45-64 remained the most affected, there was an overall proportional decrease from 46.7% in 2012 to 33.3% in 2018 (p=0.003, figure 1B). Generally, South remained the most affected region (p=0.42) throughout the study period. There was a significant decrease in the West from 23.0% to 13.2% (p=0.009) with a concurrent increase in the Midwest from 11.2% to 21.1% (p< 0.0001). A proportional decrease in the number of hospitalizations was seen at urban non-teaching hospitals (48.0% to 26.3%, p< 0.0001, figure 1C), while the number increased at urban teaching hospitals (48.7% to 69.7%, p< 0.0001, figure 1C). Mean length of hospital stay ranged from 5.6 ± 0.5 to 9.0 ± 1.3 days (p=0.93). Overall mortality ranged from 0.0% to 2.6% (p=0.009, figure 1D). Some of the most associated comorbid conditions with infections due to gastric band procedure were obesity, hypertension, fluid and electrolyte disorders, diabetes without complications, and deficiency anemias (figure 2).
Discussion: During the study period, the annual number of hospitalizations with infections due to gastric band procedure showed a downward trend with an overall low inpatient mortality and interesting demographic variations. Further studies are needed to identify factors responsible for such trends to better understand and potentially support our findings.
