Garg Trit, Rosas Ulysses, Rogan Daniel, Hines Harrison, Rivas Homero, Morton John M, Azagury Dan
Bariatric and Minimally Invasive Surgery, Stanford School of Medicine, Stanford, USA.
, 300 Pasteur Drive, H3680, Stanford, CA, 94305, USA.
J Gastrointest Surg. 2016 Nov;20(11):1797-1801. doi: 10.1007/s11605-016-3247-3. Epub 2016 Sep 9.
Readmissions are an important quality metric for surgery. Here, we compare characteristics of readmissions across laparoscopic Roux-en-Y gastric bypass (LRYGB), sleeve gastrectomy (LSG), and adjustable gastric band (LAGB).
Demographic, intraoperative, anthropometric, and laboratory data were prospectively obtained for 1775 patients at a single academic institution. All instances of readmissions within 1 year were recorded. Data were analyzed using STATA, release 12.
For the 1775 patients, 113 (6.37 %) were readmitted. Mean time to readmission was 52.1 days. Of all the readmissions, 64.6 % were within 30 days, 22.1 % from 30 to 90 days, 1.77 % from 90 to 180 days, and 11.5 % from 180 to 365 days. Incidence of 30-day readmissions varied across surgeries (LRYGB: 7.17 %; LAGB: 3.05 %; LSG: 4.25 %, p = 0.04). Time to readmission varied as well, with 90.0 % of LSG and 80.0 % of LABG patients within the first 30 days, versus 60.8 % of LRYGB (p = 0.02). The most common causes of readmissions were gastrointestinal issues related to index procedure (34.5 %) and did not vary across surgeries. In multivariable logistic regression, index hospital length of stay (LOS) was associated with readmission (OR = 1.07, 95 % CI 1.02-1.13, p = 0.01).
Readmissions after bariatric surgery are associated with high index hospital LOS, and a measureable proportion of procedure-related readmissions can occur up to 1 year, especially for LRYGB.
再入院是手术的一项重要质量指标。在此，我们比较了腹腔镜Roux-en-Y胃旁路术（LRYGB）、袖状胃切除术（LSG）和可调节胃束带术（LAGB）后再入院的特征。
前瞻性收集了一家学术机构1775例患者的人口统计学、术中、人体测量学和实验室数据。记录了1年内所有再入院情况。使用STATA 12版软件对数据进行分析。
1775例患者中，113例（6.37%）再次入院。再入院的平均时间为52.1天。在所有再入院患者中，64.6%在30天内，22.1%在30至90天之间，1.77%在90至180天之间，11.5%在180至365天之间。不同手术的30天再入院发生率有所不同（LRYGB：7.17%；LAGB：3.05%；LSG：4.25%，p = 0.04）。再入院时间也有所不同，LSG患者90.0%和LABG患者80.0%在前30天内再入院，而LRYGB患者为60.8%（p = 0.02）。再入院最常见的原因是与初次手术相关的胃肠道问题（34.5%），且在不同手术中无差异。在多变量逻辑回归分析中，初次住院时间（LOS）与再入院相关（OR = 1.07，95% CI 1.02 - 1.13，p = 0.01）。
减肥手术后的再入院与初次住院时间长有关，且相当一部分与手术相关的再入院可在1年内发生，尤其是LRYGB手术。
