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袖状胃切除术后影响30天急诊就诊和再入院的因素:来自社区减肥中心的结果

Factors influencing 30-day emergency visits and readmissions after sleeve gastrectomy: results from a community bariatric center.

作者信息

Willson Thomas D, Gomberawalla Ameer, Mahoney Kimberley, Lutfi Rami E

机构信息

Department of Surgery, Saint Joseph Hospital, Chicago, IL, USA,

出版信息

Obes Surg. 2015 Jun;25(6):975-81. doi: 10.1007/s11695-014-1546-x.

DOI:10.1007/s11695-014-1546-x
PMID:25528568
Abstract

INTRODUCTION

Bariatric surgery has proven safe and effective for long-term weight loss in morbidly obese patients. Readmissions within 30 days of discharge have become an important metric for quality of care. Sleeve gastrectomy is a common bariatric procedure, but data regarding early readmission is sparse. The purpose of this study is to determine what, if any, demographic or technical factors influence returns to the hospital or readmission following sleeve gastrectomy.

METHODS

All laparoscopic sleeve gastrectomies (n = 200) performed at a single community hospital from February 2009 to November 2012 were retrospectively reviewed. Demographic, technical, length of stay, return to Emergency Department (ED) and readmission data were gathered for each patient. The data were analyzed to determine what factors were related to early return to the Emergency Department or readmission.

RESULTS

Demographics were similar to other studies, with a male to female ratio of 1:4. Patients returning to the ED or readmitted within 30 days were statistically younger than those not returning. None of the other demographic, social, technical, or comorbid conditions considered were associated with a statistically significant risk of readmission or return to the ED within 30 days.

CONCLUSION

Although the only statistically significant difference among the groups studied was age, trends toward significance exist in minority ethnicity and comorbid asthma. These factors have been associated with increased complications in other types of surgery. Larger, multi-institutional studies are needed to further evaluate these and other risk factors for readmission following bariatric surgery.

摘要

引言

减肥手术已被证明对病态肥胖患者的长期体重减轻是安全有效的。出院后30天内的再入院率已成为衡量医疗质量的一项重要指标。袖状胃切除术是一种常见的减肥手术,但关于早期再入院的数据很少。本研究的目的是确定哪些人口统计学或技术因素(如果有的话)会影响袖状胃切除术后的医院复诊或再入院情况。

方法

对2009年2月至2012年11月在一家社区医院进行的所有腹腔镜袖状胃切除术(n = 200)进行回顾性研究。收集了每位患者的人口统计学、技术、住院时间、返回急诊科(ED)和再入院数据。对数据进行分析,以确定哪些因素与早期返回急诊科或再入院有关。

结果

人口统计学特征与其他研究相似,男女比例为1:4。在30天内返回急诊科或再次入院的患者在统计学上比未返回的患者更年轻。所考虑的其他人口统计学、社会、技术或合并症情况均与30天内再入院或返回急诊科的统计学显著风险无关。

结论

虽然在所研究的组中唯一具有统计学显著差异的是年龄,但少数族裔和合并哮喘存在显著趋势。这些因素在其他类型的手术中与并发症增加有关。需要进行更大规模的多机构研究,以进一步评估这些因素以及减肥手术后再入院的其他风险因素。

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