Association between obesity and risk of delayed discharge and unplanned readmission for day surgery: A systematic review and meta-analysis

AimsThis work aims to investigate the association between obesity and risk of delayed discharge and unplanned readmission in day surgery patients.BackgroundDay surgeries are well received and developing rapidly. Associations between obesity and delayed discharge and unplanned readmission, which are clinically relevant outcomes in day surgeries, are complex.DesignA systematic review and meta-analysis was conducted.Data SourcesThe PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, VIP, and Wan Fang databases were comprehensively searched from inception until January 2021.Review MethodsTwo independent reviewers assessed the studies and extracted data. Pooled estimates were obtained using a random-effects model.ResultsEleven articles published between 2007 and 2020 were finally included. Obesity appeared not to increase the risk of delayed discharge. However, morbid obesity seemed to be associated with a higher risk of delayed discharge. The meta-analysis revealed no relationship between higher body mass index (BMI) and unplanned readmission for day surgery patients.ConclusionsObesity appeared not to increase the risk of delayed discharge except in patients with morbid obesity. Additionally, a higher BMI was not associated with increased risk of unplanned readmission after day surgery. Future studies are required to address this issue further in different types of surgery and areas. What is already known about this topic?The complexity and flexibility of day surgeries have gradually broadened, but selecting the most suitable patients for day surgery is important for safety.Controversies exist on the association between obesity and risk of delayed discharge and unplanned readmission in day surgery patients.What this paper adds?This systematic review and meta-analysis suggests that obesity did not significantly increase the risk of delayed discharge except in patients with morbid obesity.A higher BMI was not associated with increased risk of unplanned readmission after day surgery.The implications of this paper:Obesity should not be regarded as a contraindication to day surgery although patients with morbid obesity should be scheduled with caution and evaluated on a case-by-case basis. Future studies are required to address this issue further in more types of surgery and in different areas.