Department of Psychology, Central Michigan University, Mount Pleasant, Michigan.
Department of Behavioral Health, Gundersen Health System, La Crosse, Wisconsin.
Surg Obes Relat Dis. 2021 Sep;17(9):1611-1615. doi: 10.1016/j.soard.2021.05.014. Epub 2021 May 15.
The benefits of bariatric surgery are well-established, however, concerns surrounding postoperative psychiatric destabilization and alcohol misuse remain. Research has initiated the process of identifying risks associated with bariatric surgery, although less is known regarding when or why psychiatric hospitalizations occur postoperatively.
The goal of the current study was to examine the incidence of, and contributing factors to, behavioral health-related emergency room (ER) encounters and hospitalization after bariatric surgery.
Integrated multispecialty health system with an accredited bariatric surgery program.
Retrospective review of patients who underwent Roux-en-Y gastric bypass (RYGB) surgery and had been readmitted to the hospital or presented to the ER after bariatric surgery at least once for a behavioral-health related reason.
Of 1449 patients, 93 had at least 1 psychiatric or substance use-related ER visit/hospitalization post-surgery and were included in the study; 53% had 1 ER/hospital encounter after bariatric surgery; 24% had 2 encounters, 11% had 3-4 encounters, and 10% of patients had ≥5 encounters. Across 267 postbariatric surgery encounters, 42.4% were due to alcohol-related problems. The index presentation for alcohol-related reasons occurred at a mean of 1942 days (approximately 5.3 yr; SD = 1217 d). Patients' index presentation for a psychiatric concern (41.3%) occurred at a mean of 1278 days (3.5 yr; SD = 1056 d) post-surgery.
A significant percentage of patients who present to the ER or hospital for behavioral health reasons after RYGB surgery had alcohol-related problems, long after their surgery. Psychologists working with bariatric surgery teams should prioritize ongoing assessment of and education on alcohol misuse in those seeking RYGB and in the long-term postoperative period.
减重手术的益处已得到充分证实，然而，人们仍然对术后精神不稳定和酗酒问题感到担忧。研究已经开始确定与减重手术相关的风险，但对于术后何时或为何会出现精神科住院的情况知之甚少。
本研究旨在探讨减重手术后因行为健康相关原因而到急诊室（ER）就诊或住院的发生率及相关因素。
一家拥有认证减重手术项目的综合性多专科医疗系统。
回顾性分析接受 Roux-en-Y 胃旁路术（RYGB）且至少因一次行为健康相关原因而在减重手术后再次住院或到 ER 就诊的患者。
在 1449 名患者中，有 93 名患者在减重手术后至少有 1 次因精神或物质使用相关的 ER 就诊/住院，他们被纳入研究；53%的患者在减重手术后有 1 次 ER/住院就诊；24%的患者有 2 次就诊，11%的患者有 3-4 次就诊，10%的患者有≥5 次就诊。在 267 次减重手术后就诊中，有 42.4%是由于酒精相关问题。因酒精相关问题就诊的患者平均在术后 1942 天（约 5.3 年；SD=1217d）出现首发症状。因精神问题就诊的患者首发症状出现在术后 1278 天（3.5 年；SD=1056d）。
相当一部分因行为健康原因到 ER 或医院就诊的 RYGB 术后患者存在酒精相关问题，且在术后很长一段时间内都存在该问题。与减重手术团队合作的心理学家应优先对寻求 RYGB 手术的患者以及术后长期进行酒精滥用的评估和教育。
