Type 2 Diabetes and HbA1c Predict All-Cause Post-Metabolic and Bariatric Surgery Hospital Readmission.
Type 2 Diabetes and HbA1c Predict All-Cause Post-Metabolic and Bariatric Surgery Hospital Readmission.
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DOI：
10.1002/oby.23044
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发表时间：
2021-01
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这项分析的主要目的是确定2型糖尿病和糖化血红蛋白是否能预测代谢和减肥手术(MBS)后30天的全原因再住院。据推测，诊断为2型糖尿病或HbA1c升高将预测MBS后全原因再住院率。对2015-2018年代谢和减肥手术认证和质量改进计划(MBSAQIP)队列的回顾分析已经完成(n=744,776)；30,972名参与者在MBS后30天再次入院。MBSAQIP样本的平均年龄为45.1(±11.5)岁，多数为女性(80.7%)，非西班牙裔白人(59.4%)。全原因再住院率为4.2%，在那些未得到控制的2型糖尿病患者中增加了10%(HbA1c和Gt；7.5%[>；58 mmol/mol])；调整后，糖尿病与再次入院的增加无关。未控制的2型糖尿病、2型糖尿病和糖尿病前期患者在MBS后30天体重下降较少。我们基于全国MBS队列的结果显示，未控制的2型糖尿病与全原因再次住院的可能性更大，MBS后30天体重减轻的可能性更大。2型糖尿病和前驱糖尿病也都与MBS后30天体重下降有关。我们的发现强调了在MBS之前对血糖控制进行分类和优化的必要性。
The main goal of this analysis was to determine if type 2 diabetes and HbA1c predict all-cause 30-day hospital readmission post-metabolic and bariatric surgery (MBS). It was hypothesized that a diagnosis of type 2 diabetes or high HbA1c values would predict all-cause hospital readmission rates post-MBS. A retrospective analysis from the 2015–2018 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) cohort was completed (n= 744,776); 30,972 participants were readmitted during the 30-day post-MBS. Mean age of the MBSAQIP sample was 45.1 (±11.5) years, majority female (80.7%) and non-Hispanic white (59.4%). All-cause hospital readmission rate was 4.2% and increased by 10% in those with uncontrolled type 2 diabetes (HbA1c >7.5% [>58 mmol/mol]); after adjustment, diabetes was not associated with increased re-admission. Uncontrolled type 2 diabetes, type 2 diabetes, and prediabetes resulted in less weight loss 30-day post-MBS. Our results based on a national MBS cohort showed that uncontrolled type 2 diabetes is associated with a greater likelihood of all-cause hospital readmission and reduced weight loss 30-day post-MBS. Both, type 2 diabetes and prediabetes were also associated with decreased weight loss 30-day post-MBS. Our findings highlight the need to classify and optimize glycemic control prior to MBS.