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沙特阿拉伯医院减重手术后的再入院及急诊科就诊情况:发生率、原因及风险因素

Readmissions and Emergency Department Visits after Bariatric Surgery at Saudi Arabian Hospital: The Rates, Reasons, and Risk Factors.

作者信息

Ahmed Anwar, AlBuraikan Doaa, ALMuqbil Bashayr, AlJohi Wijdan, Alanazi Wala, AlRasheed Budor

机构信息

King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.

出版信息

Obes Facts. 2017;10(5):432-443. doi: 10.1159/000456667. Epub 2017 Oct 7.

Abstract

BACKGROUND

Saudi Arabian hospital readmissions and emergency department (ED) visits following bariatric surgery and discharge have never been investigated. This study aimed to evaluate the rates and reasons of hospital readmissions and ED visits related to surgical weight loss interventions at the King Abdulaziz Medical City - Riyadh.

METHODS

We conducted a retrospective cohort study on 301 patients who underwent bariatric surgery between January 2011 and July 2016. We reviewed patient medical records progressively to assess hospital readmission, ED visits, and complications.

RESULTS

Of the 301 patients analyzed, 67.1% were female and 93% had class II obesity. The readmission rate, ED visit rate after discharge and the rate of either of the two was 8%, 14%,and 18.3%, respectively. The most common causes of readmission were abdominal pain (37.5%), nausea/vomiting (29.2%), and site leak (25%), while the most common causes of ED visits were abdominal pain (59.5%) and nausea/vomiting (16.9%). Readmission rates tended to be higher in older patients (age of patients readmitted 42 ± 12.1 years vs. age of patients not readmitted 34.3 ± 11.8 years; p = 0.002). The rate of readmission tends to increase in patients with overweight or class I obesity (odds ratio (OR) = 20.15), diabetes (OR = 14.82), and obstructive sleep apnea (OR = 14.29). Dyslipidemia was positively associated with ED visits (p = 0.027, OR = 2.87). The rate of readmission or ED visits increased with age, while there were decreases in readmission and ED visits for those who had received gastric sleeve surgery.

CONCLUSIONS

The study reported high rates of readmission and ED visits, thus the effectiveness of different types of weight loss surgeries should be further evaluated, particularly in individuals with complicated medical issues such as diabetes, dyslipidemia, and obstructive sleep apnea.

摘要

背景

沙特阿拉伯医院对减肥手术后出院患者的再入院情况和急诊就诊情况从未进行过调查。本研究旨在评估利雅得阿卜杜勒阿齐兹国王医疗城与手术减肥干预相关的医院再入院率及原因和急诊就诊率及原因。

方法

我们对2011年1月至2016年7月间接受减肥手术的301例患者进行了一项回顾性队列研究。我们逐步查阅患者病历,以评估医院再入院情况、急诊就诊情况及并发症。

结果

在分析的301例患者中,67.1%为女性,93%患有II级肥胖症。再入院率、出院后急诊就诊率以及两者之一的发生率分别为8%、14%和18.3%。再入院的最常见原因是腹痛(37.5%)、恶心/呕吐(29.2%)和手术部位渗漏(25%),而急诊就诊的最常见原因是腹痛(59.5%)和恶心/呕吐(16.9%)。老年患者的再入院率往往更高(再入院患者年龄42±12.1岁,未再入院患者年龄34.3±11.8岁;p = 0.002)。超重或I级肥胖患者(优势比(OR)= 20.15)、糖尿病患者(OR = 14.82)和阻塞性睡眠呼吸暂停患者(OR = 14.29)的再入院率往往会增加。血脂异常与急诊就诊呈正相关(p = 0.027,OR = 2.87)。再入院率或急诊就诊率随年龄增长而增加,而接受胃袖状切除术的患者的再入院率和急诊就诊率有所下降。

结论

该研究报告了较高的再入院率和急诊就诊率,因此应进一步评估不同类型减肥手术的有效性,尤其是在患有糖尿病、血脂异常和阻塞性睡眠呼吸暂停等复杂医疗问题的个体中。

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