Hofer Roger E, Kai Tetsuya, Decker Paul A, Warner David O
Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Mayo Clin Proc. 2008 Aug;83(8):908-16. doi: 10.4065/83.8.908.
To test the hypothesis that obesity is an independent risk factor for unplanned hospital admission or readmission among patients scheduled for ambulatory surgery in a tertiary medical center.
Existing databases were used to identify 235 obese patients (body mass index [BMI] >40) scheduled for ambulatory surgery from January 2, 2002, through December 31, 2003, at Mayo Clinic's site in Rochester, MN. Each patient was matched to a normal-weight control (BMI <25) by age, sex, surgical procedure, type of anesthesia, and date of surgery, and the medical records of all patients were reviewed. Conditional logistic regression analysis was performed to assess whether obesity is an independent risk factor for unplanned postoperative hospital admission. In all cases, 2-sided tests were performed. P<.05 was considered statistically significant.
Obese patients (mean +/- SD BMI, 44+/-4) were matched with control patients (mean +/- SD BMI, 23+/-2). Comorbidity was more frequent in the obese cohort. The frequency of unplanned hospital admission did not differ between groups: 61 obese patients (26.0%) and 52 control patients (22.1%) were admitted (odds ratio, 1.3; 95% confidence interval, 0.8-2.0; P=.30).
Obesity is not a significant independent risk factor for unplanned admission after ambulatory surgery, suggesting that obesity per se should not prevent ambulatory surgery from being scheduled.
检验肥胖是三级医疗中心门诊手术患者计划外住院或再入院的独立危险因素这一假设。
利用现有数据库，确定2002年1月2日至2003年12月31日在明尼苏达州罗切斯特市梅奥诊所接受门诊手术的235例肥胖患者（体重指数[BMI]>40）。根据年龄、性别、手术方式、麻醉类型和手术日期，将每位患者与体重正常的对照者（BMI<25）进行匹配，并查阅所有患者的病历。进行条件逻辑回归分析，以评估肥胖是否是计划外术后住院的独立危险因素。在所有情况下，均进行双侧检验。P<0.05被认为具有统计学意义。
肥胖患者（平均±标准差BMI，44±4）与对照患者（平均±标准差BMI，23±2）相匹配。肥胖队列中的合并症更为常见。两组间计划外住院的频率无差异：61例肥胖患者（26.0%）和52例对照患者（22.1%）入院（比值比，1.3；95%置信区间，0.8 - 2.0；P = 0.30）。
肥胖不是门诊手术后计划外入院的显著独立危险因素，这表明肥胖本身不应妨碍安排门诊手术。
