Department of General Surgery, Faculty of Medicine, The University of Jordan, Amman, Jordan.
Faculty of Medicine, The University of Jordan, Amman, Jordan.
Medicine (Baltimore). 2024 Aug 9;103(32):e39242. doi: 10.1097/MD.0000000000039242.
Avoidable readmissions after bariatric surgery are a major burden on the healthcare systems. Rates of readmission after bariatric surgery have ranged from 1% up to 20%, but the factors that predict readmission have not been well studied. The objective of this study was to determine readmission rates following bariatric surgery and identify factors that contribute to early (within 90 days of surgery) and late readmission. A retrospective cohort study of 736 patients undergoing either Laparoscopic Sleeve Gastrectomy or Laparoscopic Roux-en-Y Gastric Bypass in Jordan University Hospital from 2016 to 2019. Demographic characteristics, co-morbidities, and readmissions were extracted from their medical records and analyzed. Multivariable logistic regression analysis was performed to determine which factors predict readmission. A total of 736 patients had bariatric surgery (Laparoscopic Sleeve Gastrectomy 89% vs Laparoscopic Roux-en-Y Gastric Bypass 11%) during the study period. Thirty-day readmission rate was 6.62% and an overall readmission rate of 23.23%. Common reasons for early readmission (within 90 days of surgery) were nausea, vomiting, and dehydration. Late readmissions were mainly caused by gallbladder stones. Three risk factors were identified that independently predicted readmission: the type of procedure being performed (P-value = .003, odds ratio [OR] 2.14, 95% confidence interval [CI] 1.32-3.49), depression (P-value = .028, OR 6.49, 95% CI 1.18-52.9) and preoperative body mass index (P-value = .011, OR 1.03, 95% CI 1.01-1.05). Several factors were identified that cause patients to represent and subsequently admitted into hospitals. Early readmission was usually due to nausea, vomiting, and dehydration, whereas late admissions were mostly due to biliary complications. Preoperative body mass index and depression were independent risk factors for readmission.
减重手术后的可避免再入院是医疗系统的主要负担。减重手术后的再入院率范围从 1%到 20%不等,但预测再入院的因素尚未得到很好的研究。本研究的目的是确定减重手术后的再入院率,并确定导致早期(手术 90 天内)和晚期再入院的因素。这是一项回顾性队列研究,纳入了 2016 年至 2019 年在约旦大学医院接受腹腔镜袖状胃切除术或腹腔镜 Roux-en-Y 胃旁路术的 736 例患者。从他们的病历中提取人口统计学特征、合并症和再入院情况,并进行分析。采用多变量逻辑回归分析确定哪些因素预测再入院。研究期间共有 736 例患者接受了减重手术(腹腔镜袖状胃切除术 89% vs 腹腔镜 Roux-en-Y 胃旁路术 11%)。30 天再入院率为 6.62%,总再入院率为 23.23%。早期再入院(手术 90 天内)的常见原因是恶心、呕吐和脱水。晚期再入院主要由胆囊结石引起。确定了三个独立预测再入院的危险因素:手术类型(P 值=0.003,比值比[OR]2.14,95%置信区间[CI]1.32-3.49)、抑郁(P 值=0.028,OR 6.49,95% CI 1.18-52.9)和术前体重指数(P 值=0.011,OR 1.03,95% CI 1.01-1.05)。确定了一些导致患者代表并随后入院的因素。早期再入院通常是由于恶心、呕吐和脱水,而晚期入院主要是由于胆道并发症。术前体重指数和抑郁是再入院的独立危险因素。