PDF(Pubmed)
Abstract：
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.
摘要：
减肥手术后可避免的再入院是医疗保健系统的主要负担。减肥手术后的再入院率从1%到20%不等，但是预测再入院的因素还没有得到很好的研究。这项研究的目的是确定减肥手术后的再入院率，并确定导致早期（手术后90天内）和晚期再入院的因素。一项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胃旁路手术的736例患者的回顾性队列研究。人口特征，合并症,从他们的医疗记录中提取并分析再入院。进行多变量逻辑回归分析以确定哪些因素可以预测再入院。在研究期间，共有736例患者接受了减肥手术（腹腔镜袖状胃切除术89％，腹腔镜Roux-en-Y胃旁路术11％）。30天再入院率为6.62%，总体再入院率为23.23%。早期再入院（手术后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风险因素：正在进行的手术类型（P值=.003，比值比[OR]2.14，95％置信区间[CI]1.32-3.49），抑郁（P值=0.028，OR6.49，95％CI1.18-52.9）和术前体重指数（P值=0.011，OR1.03，95％CI1.01-1.05）。确定了导致患者代表并随后入院的几个因素。早期再入院通常是由于恶心，呕吐,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次入院的独立危险因素。
