Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, 182 East 210th Street, Lower Level, Bronx, NY, 10467, USA.
The Albert Einstein College of Medicine, Bronx, NY, USA.
Obes Surg. 2018 May;28(5):1225-1231. doi: 10.1007/s11695-017-2993-y.
This study's objective was to describe our experience and evaluate the safety of early discharge (ED) following laparoscopic Roux-en-Y gastric bypass (LRYGB) in a specific patient population.
Patients undergoing LRYGB at Montefiore Medical Center were retrospectively reviewed. Patients readmitted in the first 30 days following surgery were compared to those patients who were not readmitted. Data analysis was used to compare groups and to determine factors associated with readmission. In addition to patient demographics, length of stay (LOS) was analyzed as an independent risk factor for readmission.
A total of 630 LRYGB were performed during this period. There were 5.1% (n = 32) of patients that required readmission within 30 days of discharge. Readmitted patients had a higher BMI (50.0 vs. 45.8; p = 0.006) and there was a trend for them to be younger (38.4 years vs. 42.0; p = 0.07). There was an increased rate of ED in 2015 (36.7%, n = 121) compared to 2014 (29.9%, n = 90). The readmission rate for ED for the study period was 4.7% (n = 10). There were no observed mortalities in our early discharge group of patients.
Discharge on post-operative day 1 following a LRYGB is safe and is not associated with an increased likelihood of being readmitted within 30 days of discharge. Our single-center experience helps to better characterize current patient profiles and length of stay trends within the field and can be used to establish a randomized controlled trial for discharging patients early after LRYGB.
本研究旨在描述我们在特定患者人群中进行腹腔镜 Roux-en-Y 胃旁路术（LRYGB）后早期出院（ED）的经验，并评估其安全性。
回顾性分析在 Montefiore 医疗中心接受 LRYGB 的患者。比较术后 30 天内再入院的患者与未再入院的患者。数据分析用于比较组间差异，并确定与再入院相关的因素。除了患者人口统计学特征外，还分析了住院时间（LOS）作为再入院的独立危险因素。
在此期间共进行了 630 例 LRYGB。有 5.1%（n=32）的患者在出院后 30 天内需要再次入院。再入院患者的 BMI 更高（50.0 比 45.8；p=0.006），且年龄呈年轻化趋势（38.4 岁比 42.0 岁；p=0.07）。2015 年 ED 的出院率为 36.7%（n=121），高于 2014 年的 29.9%（n=90）。研究期间 ED 的再入院率为 4.7%（n=10）。在我们的早期出院组患者中没有观察到死亡病例。
LRYGB 术后第 1 天出院是安全的，与出院后 30 天内再入院的可能性增加无关。我们的单中心经验有助于更好地描述当前患者特征和住院时间趋势，并可用于建立 LRYGB 后早期出院的随机对照试验。
