University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Surg Endosc. 2023 Oct;37(10):8091-8098. doi: 10.1007/s00464-023-10369-3. Epub 2023 Sep 7.
This retrospective cohort study aims to investigate emergency department (ED) visits and readmission after bariatric surgery among patients with a history of anxiety and/or depression. We predict that patients with a reported history of anxiety and/or depression will have more ED visits in the year following surgery than patients without a history of mental illness.
Data were collected from the charts of all consecutive patients who underwent sleeve gastrectomy or gastric bypass surgery between March 2012 and December 2019. Data on baseline body mass index, mental health diagnosis and treatment and emergency department visits and hospital readmissions were retrospectively reviewed over the first year following surgery.
One thousand two hundred ninety-seven patients were originally included in this study and 1113 patients were included in the final analysis. Patients with a history of depression (OR 1.23; 95% CI 0.87-1.73), anxiety (OR 1.14; 95% CI 0.81-1.60), or both (OR 1.17; 95% CI 0.83-1.65) did not have a statistically significant increase in ED visits compared to patients without these disorders. Patients with a history of depression (OR 1.49; 95% CI 0.86-2.61), anxiety (OR 1.45; 95% CI 0.80-2.65) or both (OR 1.47; 95% CI 0.94-2.29) did not have a statistically significant increase in hospital readmissions in the first year after surgery compared to patients without these disorders. Patients treated with a sleeve gastrectomy were readmitted due to postoperative complications less frequently than those treated with other surgeries (OR 0.20; 95% CI 0.05-0.83).
Patients with a history of anxiety, depression or both did not have an increased rate of emergency department visits and hospital readmissions within the first year following bariatric surgery. This contradicts current literature and may be due to the multidisciplinary program patients undergo at this study's home institution.
本回顾性队列研究旨在调查有焦虑和/或抑郁病史的患者在接受减重手术后的急诊就诊和再入院情况。我们预测，与无精神疾病史的患者相比，报告有焦虑和/或抑郁病史的患者在手术后的一年内急诊就诊次数会更多。
本研究的数据来自于 2012 年 3 月至 2019 年 12 月间连续接受袖状胃切除术或胃旁路手术的所有患者的病历。回顾性分析了手术前一年的基线体重指数、精神健康诊断和治疗以及急诊就诊和住院再入院的数据。
最初有 1297 名患者被纳入本研究，最终有 1113 名患者被纳入最终分析。与无这些疾病的患者相比，有抑郁史（OR 1.23；95%CI 0.87-1.73）、焦虑史（OR 1.14；95%CI 0.81-1.60）或两者均有的患者急诊就诊次数并没有统计学上的显著增加。与无这些疾病的患者相比，有抑郁史（OR 1.49；95%CI 0.86-2.61）、焦虑史（OR 1.45；95%CI 0.80-2.65）或两者均有的患者在手术后的第一年住院再入院率并没有统计学上的显著增加。与接受其他手术的患者相比，接受袖状胃切除术的患者因术后并发症再入院的频率较低（OR 0.20；95%CI 0.05-0.83）。
有焦虑、抑郁或两者均有的患者在接受减重手术后的一年内急诊就诊和住院再入院率没有增加。这与当前的文献相矛盾，可能是由于患者在本研究所在机构接受了多学科治疗计划。
