The relationship between duration of stay and readmissions in patients undergoing bariatric surgery
The relationship between duration of stay and readmissions in patients undergoing bariatric surgery
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DOI：
10.1016/j.surg.2015.03.051
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发表时间：
2015-08-01
期刊：
影响因子：
3.8
通讯作者：
Gould, Jon C.
中科院分区：
文献类型：
--
作者：
Lois, Alex W.;Frelich, Matthew J.;Gould, Jon C.
背景资料。在减肥手术中，再次住院是一个质量指标。近年来，减肥手术后的住院时间有大幅下降的趋势。我们假设较短的术后住院时间不会增加再入院的可能性。大学卫生系统联盟(UHC)是学术医疗中心和附属医院的联盟。UHC的临床数据库包含出院后30天内住院和返回(再次入院)的信息。通过使用2009年1月至2013年12月的数据，对18岁和老年患者的预后进行多中心分析，这些患者是通过减肥手术国际疾病分类第9版、代码和病态肥胖诊断代码确定的。共有95,294名患者符合纳入标准。患者平均年龄为45.4(+/-0.11)岁，其中73941例(77.6%)为女性。在研究期间，有5423人(5.7%)再次入院。住院3天和3天以上的患者再入院的可能性分别是住院1天的患者的2倍和4倍(P<；.001)。术后住院时间较长的患者更有可能在减肥手术后再次住院。早期出院似乎与再入院率的增加无关。
Background. Hospital readmissions are a quality indicator in bariatric surgery. In recent years, duration of stay after bariatric surgery has trended down greatly. We hypothesized that a shorter postoperative hospitalization does not increase the likelihood of readmission.Methods. The University HealthSystem Consortium (UHC) is an alliance of academic medical centers and affiliated hospitals. The UHC's clinical database contains information on inpatient stay and returns (readmissions) up to 30 days after discharge. A multicenter analysis of outcomes was performed by the use of data from the January 2009 to December 2013 for patients 18 years and olden Patients were identified by bariatric procedure International Classification of Diseases, Ninth Revision, codes and restricted by diagnosis codes for morbid obesity.Results. A total of 95,294 patients met inclusion criteria. The mean patient age was 45.4 (+/- 0.11) years, and 73,941 (77.6%) subjects were female. There were 5,423 (5.7%) readmissions within the study period. Patients with hospitalizations of 3 days and more than 3 days were twice and four times as likely to be readmitted than those with hospitalizations of one day, respectively (P < .001).Conclusion. Patients with longer postoperative hospitalizations were more likely to be readmitted after bariatric surgery. Early discharge does not appear to be associated with increased readmission rates.