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肥胖症手术后立即入住重症监护病房与普通住院病房的对比。一项针对828名患者的回顾性研究。

Immediate postoperative of bariatric surgery in the intensive care unit versus an inpatient unit. A retrospective study with 828 patients.

作者信息

Penna Guilherme Loures de Araújo, Vaz Igor Pedreira, Fonseca Eduardo Côrtes, Kalichsztein Marcelo, Nobre Gustavo Freitas

机构信息

Unidade de Terapia Intensiva, Casa de Saúde São José - Rio de Janeiro (RJ), Brasil.

Universidade Estácio de Sá - Rio de Janeiro (RJ), Brasil.

出版信息

Rev Bras Ter Intensiva. 2017 Jul-Sep;29(3):325-330. doi: 10.5935/0103-507X.20170050.

Abstract

OBJECTIVE

To compare the incidence of complications and the duration of hospitalization of patients undergoing bariatric surgery admitted to the intensive care unit or a post-surgical hospitalization unit.

METHODS

This retrospective observational study included 828 patients admitted between January 2010 and February 2015 during the immediate postoperative period of bariatric surgery in a hospital. Data were collected via electronic medical records. The Mann-Whitney test was used to compare continuous variables, and the chi-square was used to compare categorical variables.

RESULTS

Patients in both groups had similar demographic characteristics, with no significant differences in anthropometric data and comorbidities. There was no significant difference in the comparison of complications between the two groups. However, the group admitted to the intensive care unit had longer hospitalization times (median of 3 days versus 2 days, p < 0.05), and hospital costs were 8% higher.

CONCLUSION

The present study found no benefit in the routine admittance of patients to the intensive care unit after undergoing bariatric surgery. This practice increased hospitalization time and hospital costs, which wasted resources. It is necessary to create objective criteria to identify patients requiring intensive care unit admission after bariatric surgery.

摘要

目的

比较接受减肥手术的患者入住重症监护病房或术后住院病房的并发症发生率及住院时间。

方法

这项回顾性观察研究纳入了2010年1月至2015年2月期间在一家医院接受减肥手术术后即刻的828例患者。数据通过电子病历收集。采用曼-惠特尼检验比较连续变量,采用卡方检验比较分类变量。

结果

两组患者的人口统计学特征相似,人体测量数据和合并症方面无显著差异。两组并发症比较无显著差异。然而,入住重症监护病房的组住院时间更长(中位数为3天对2天,p<0.05),住院费用高出8%。

结论

本研究发现减肥手术后患者常规入住重症监护病房并无益处。这种做法增加了住院时间和住院费用,造成了资源浪费。有必要制定客观标准以识别减肥手术后需要入住重症监护病房的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a777/5632975/7eee671eb34b/rbti-29-03-0325-g01.jpg

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