Remote Patient Monitoring Following Same-Day Discharge Bariatric Surgery: A Systematic Review and Meta-analysis.

Abstract

Background: A barrier to same-day discharge (SDD) in bariatric and metabolic surgery (BMS) is concern over missing the early signs of complication, often detected by measurement of physiological observations. Remote patient monitoring has gained popularity in other surgeries; however, its effectiveness in BMS remains uncertain. This systematic review aims to examine the impact of remote monitoring (RM) on postoperative readmissions and complications in patients undergoing SDD after BMS.

Methods: A literature search of Embase, Ovid MEDLINE, and Cochrane Central databases was conducted to identify all studies on RM used in SDD in bariatric surgery. Data were collected on patient demographics and postoperative outcomes including readmission and morbidity rates.

Results: Seventeen studies including 20,380 patients were analysed. The mean age and preoperative body mass index (BMI) of patients were 41.3 ± 2.7 years and 43.3 ± 1.6 kg/m² respectively. The incidence of readmission for patients with and without RM was 6% (95% CI 0.03-0.13) and 2% (95% CI 0.01-0.04) respectively (p = 0.01). The overall complication rates for patients with and without RM were found to be 7% (95% CI 0.04-0.13) and 3% (95% CI 0.02-0.09) (p = 0.08). Most of the patients who were readmitted had a Clavien-Dindo score of 1 or 2 (68%). There was no mortality described in studies with the use of RM.

Conclusions: SDD with RM enables a shorter hospital stay while providing a safety net for patients and clinicians; the readmission rate is expected marginally higher given the early discharge date. Future studies reporting on healthcare economics are encouraged.