Saunders John K, Ballantyne Garth H, Belsley Scott, Stephens Daniel, Trivedi Amit, Ewing Douglas R, Iannace Vincent, Capella Rafael F, Wasielewski Annette, Moran S, Schmidt Hans J
Bariatric Surgery Center, Hacekensack University Medical Center, Hackensack, NJ 07601, USA.
Obes Surg. 2007 Sep;17(9):1171-7. doi: 10.1007/s11695-007-9210-3.
Recent studies suggest that weight loss operations may actually increase the costs to society due to increased hospital readmission rates. The purpose of this study was to determine the 30-day readmission rates following bariatric operations at a high volume bariatric surgery program.
Records for all patients undergoing bariatric operations during a 3-year period were harvested from the hospital electronic medical database. All hospital readmissions within 30 days of surgery were reviewed to determine the cause, demographics, and patient characteristics. Logistic regression analysis assessed the impact of various factors on the risk of readmission.
2,823 consecutive patients were identified using the corrected operative log. Of these patients, 165 (5.8%) patients required 184 (6.5%) readmissions within 30 days of their index bariatric operation. Laparoscopic adjustable gastric banding (LAGB) had the lowest patient readmission rate of 3.1%; vertical banded gastroplasty-Roux-en-Y gastric bypass (VBG-RYGBP) 6.8% and Laparoscopic Roux-en-Y gastric bypass (LRYGBP) 7.3%. Technical considerations were the most common cause for readmission (41% of readmissions). White race and undergoing LAGB decreased the odds for readmission, while total operating-room time >120 minutes, initial hospital stay of >3 days and deep venous thrombosis increased the odds for readmission.
This study found an overall 30-day readmission rate of 6.5% following bariatric operations at a high volume bariatric surgery program. This study supports the concept of bariatric surgery Centers of Excellence and accreditation of Bariatric Surgery Programs based on hospital volume of bariatric operations.
近期研究表明，由于医院再入院率上升，减肥手术实际上可能会增加社会成本。本研究的目的是确定在一个高容量减肥手术项目中，减肥手术后30天的再入院率。
从医院电子医疗数据库中收集了3年内所有接受减肥手术患者的记录。对手术后30天内的所有医院再入院情况进行审查，以确定原因、人口统计学特征和患者特点。逻辑回归分析评估了各种因素对再入院风险的影响。
使用校正后的手术日志确定了2823例连续患者。在这些患者中，165例（5.8%）患者在初次减肥手术后30天内需要184次（6.5%）再入院。腹腔镜可调节胃束带术（LAGB）的患者再入院率最低，为3.1%；垂直带状胃成形术- Roux-en-Y胃旁路术（VBG-RYGBP）为6.8%，腹腔镜Roux-en-Y胃旁路术（LRYGBP）为7.3%。技术因素是再入院的最常见原因（占再入院的41%）。白种人和接受LAGB手术可降低再入院几率，而手术室总时间>120分钟、初始住院时间>3天和深静脉血栓形成会增加再入院几率。
本研究发现，在一个高容量减肥手术项目中，减肥手术后30天的总体再入院率为6.5%。本研究支持减肥手术卓越中心的概念以及基于减肥手术医院手术量对减肥手术项目进行认证。
