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与减重手术后 1 年患者完成调查相关的因素。

Factors associated with completion of patient surveys 1 year after bariatric surgery.

机构信息

Department of Surgery, University of Michigan, Ann Arbor, Michigan.

Michigan Bariatric Surgery Collaborative, Ann Arbor, Michigan.

出版信息

Surg Obes Relat Dis. 2021 Mar;17(3):538-547. doi: 10.1016/j.soard.2020.10.028. Epub 2020 Nov 2.

Abstract

BACKGROUND

Patient-reported outcomes (PRO) obtained from follow-up survey data are essential to understanding the longitudinal effects of bariatric surgery. However, capturing data among patients who are well beyond the recovery period of surgery remains a challenge, and little is known about what factors may influence follow-up rates for PRO.

OBJECTIVES

To assess the effect of hospital practices and surgical outcomes on patient survey completion rates at 1 year after bariatric surgery.

SETTING

Prospective, statewide, bariatric-specific clinical registry.

METHODS

Patients at hospitals participating in the Michigan Bariatric Surgery Collaborative are surveyed annually to obtain information on weight loss, medication use, satisfaction, body image, and quality of life following bariatric surgery. Hospital program coordinators were surveyed in June 2017 about their practices for ensuring survey completion among their patients. Hospitals were ranked based on 1-year patient survey completion rates between 2011 and 2015. Multivariable regression analyses were used to identify associations between hospital practices, as well as 30-day outcomes, on hospital survey completion rankings.

RESULTS

Overall, patient survey completion rates at 1 year improved from 2011 (33.9% ± 14.5%) to 2015 (51.0% ± 13.0%), although there was wide variability between hospitals (21.1% versus 77.3% in 2015). Hospitals in the bottom quartile for survey completion rates had higher adjusted rates of 30-day severe complications (2.6% versus 1.7%, respectively; P = .0481), readmissions (5.0% versus 3.9%, respectively; P = .0157), and reoperations (1.5% versus .7%, respectively; P = .0216) than those in the top quartile. While most hospital practices did not significantly impact survey completion at 1 year, physically handing out surveys during clinic visits was independently associated with higher completion rates (odds ratio, 13.60; 95% confidence interval, 1.99-93.03; P =.0078).

CONCLUSIONS

Hospitals vary considerably in completion rates of patient surveys at 1 year after bariatric surgery, and lower rates were associated with hospitals that had higher complication rates. Hospitals with the highest completion rates were more likely to physically hand surveys to patients during clinic visits. Given the value of PRO on longitudinal outcomes of bariatric surgery, improving data collection across multiple hospital systems is imperative.

摘要

背景

从随访调查数据中获取患者报告的结果(PRO)对于了解减重手术的纵向影响至关重要。然而,在手术恢复期过后很久的患者中获取数据仍然是一个挑战,并且对于哪些因素可能影响 PRO 的随访率知之甚少。

目的

评估医院实践和手术结果对减重手术后 1 年患者调查完成率的影响。

设置

前瞻性的、全州范围内的、专门针对减重手术的临床注册中心。

方法

参与密歇根州减重手术合作项目的医院每年对患者进行调查,以获取减重手术后体重减轻、药物使用、满意度、身体形象和生活质量方面的信息。2017 年 6 月,对医院项目协调员进行了调查,了解他们确保患者完成调查的实践情况。根据 2011 年至 2015 年期间的 1 年患者调查完成率对医院进行排名。使用多变量回归分析来确定医院实践以及 30 天结局与医院调查完成排名之间的关联。

结果

总体而言,1 年时患者调查完成率从 2011 年(33.9%±14.5%)提高到 2015 年(51.0%±13.0%),尽管医院之间存在很大差异(2015 年分别为 21.1%和 77.3%)。在调查完成率处于最低四分位数的医院中,30 天严重并发症的调整后发生率更高(分别为 2.6%和 1.7%;P=0.0481)、再入院率(分别为 5.0%和 3.9%;P=0.0157)和再次手术率(分别为 1.5%和 0.7%;P=0.0216)高于处于最高四分位数的医院。尽管大多数医院实践对 1 年时的调查完成情况没有显著影响,但在就诊期间亲自分发调查是与更高完成率独立相关的因素(比值比,13.60;95%置信区间,1.99-93.03;P=0.0078)。

结论

减重手术后 1 年时,医院患者调查的完成率差异很大,较低的完成率与并发症发生率较高的医院相关。完成率最高的医院更有可能在就诊期间亲自向患者发放调查问卷。鉴于 PRO 对减重手术的纵向结果具有重要价值,因此必须在多个医院系统中改进数据收集。

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