# Association of health literacy and general self-efficacy with emergency department visits for unclear abdominal pain after bariatric surgery

## TL;DR

This study found that low health literacy increases the risk of repeated emergency visits for abdominal pain after bariatric surgery.

## Contribution

The study identifies health literacy as a novel predictor of post-surgery emergency visits for abdominal pain.

## Key findings

- 29.9% of patients had at least one emergency visit for abdominal pain after bariatric surgery.
- Inadequate health literacy significantly increased the risk of repeated emergency visits.
- General self-efficacy was not significantly linked to emergency visit frequency.

## Abstract

Emergency department visits are common following bariatric surgery and may be partially preventable. Health literacy and general self-efficacy are factors that may influence health-seeking behaviors in these patients. This study aimed to assess whether health literacy and general self-efficacy are associated with an increased frequency of emergency department visits after bariatric surgery.

Patients who underwent bariatric surgery at a single hospital from 2018 to 2020 were evaluated for their health literacy and general self-efficacy levels before surgery. Data on emergency department visits within the patient’s residential region were evaluated over a three-year period, with repeated emergency department visits for abdominal pain as the primary outcome.

During the follow-up period, 69 of 231 patients (29.9%) had at least one emergency department visit for abdominal pain, and 20 patients (8.7%) had three or more visits. Inadequate functional health literacy (OR 5.56, 95% CI 1.80-17.19, p = 0.003) and inadequate communicative and critical health literacy (OR 10.48, 95% CI 3.13–35.08, p < 0.001) were both significantly associated with an increased risk of repeated emergency department visits over the three-year period. No significant association was found between low general self-efficacy and the frequency of emergency department visits.

Inadequate health literacy is associated with an increased risk of repeated emergency department visits for abdominal pain following bariatric surgery.

The online version contains supplementary material available at 10.1007/s00423-025-03736-2.