A study analyzing outcomes after bariatric surgery by primary language.
A study analyzing outcomes after bariatric surgery by primary language.
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一项按主要语言分析减肥手术后结果的研究。
DOI：
10.1007/s00464-023-10127-5
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Kelz,RachelR
中科院分区：
文献类型：
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作者：
Rosen,ClaireB;Roberts,SanfordE;Sharpe,James;Gershuni,Victoria;Altieri,MariaS;Kelz,RachelR
背景沟通是减肥手术成功的关键。本研究的目的是了解如何减肥手术后的结果与非英语的主要语言和那些与英语作为他们的主要language.MethodsThis回顾性，观察性队列研究的减肥手术患者年龄≥ 18岁利用密歇根州，马里兰州，和新泽西州住院患者数据库和国家门诊手术和服务数据库，2016年至2018年之间的差异。患者按主要口语分类：英语和非英语。主要结局为并发症。次要结局包括住院时间（LOS）和成本，成本使用医疗保健成本和利用项目提供的成本费用比计算，并以2019年美元报告。多变量回归模型（逻辑，泊松和分位数）被用来检查主要语言和结果之间的关联。由于主要语言的种族分布不均，相互作用的条款被用来检查有条件的影响race.ResultsAmong 69,749减肥手术患者，2811（4.2%）讲非英语的主要语言。协变量，特别是种族分布，和未经调整的结果差异显着的主要语言。然而，调整后，非英语母语与并发症的几率显著增加（比值比1.24，p = 0.389）、LOS显著不同（-0.02d，p = 0.677）、平均医疗费用显著不同（-265，p = 0.309）无关。有没有显着的条件效应，种族之间看到outcome.ConclusionsThough非英语的主要语言与一个显着不同的分布的可观察到的特征（包括种族，收入四分位数，保险类型），调整后，非英语的主要语言是不相关的显着差异风险减肥手术后的不良后果，也没有显着的条件效应的种族。因此，这项研究表明，减肥手术中主要口语的差异更可能与获得护理或院前和院后护理的连续性有关，而不是手术后的指数住院。图形摘要
BackgroundCommunication is key to success in bariatric surgery. This study aims to understand how outcomes after bariatric surgery differ between patients with a non-English primary language and those with English as their primary language.MethodsThis retrospective, observational cohort study of bariatric surgery patients age ≥ 18 years utilized the Michigan, Maryland, and New Jersey State Inpatient Databases and State Ambulatory Surgery and Services Databases, 2016 to 2018. Patients were classified by primary spoken language: English and non-English. Primary outcome was complications. Secondary outcomes included length of stay (LOS) and cost, with cost calculated using cost-to-charge ratios provided by Healthcare Cost and Utilization Project and reported in 2019 United States dollars. Multivariable regression models (logistic, Poisson, and quantile) were used to examine associations between primary language and outcomes. Given the uneven distribution of race by primary language, interaction terms were used to examine conditional effects of race.ResultsAmong 69,749 bariatric surgery patients, 2811 (4.2%) spoke a non-English primary language. Covariates, notably race distribution, and unadjusted outcomes differed significantly by primary language. However, after adjustment, non-English primary language was not associated with significantly increased odds of complications (odds ratio 1.24,p= 0.389), significantly different LOS (− 0.02 days,p= 0.677), nor significantly different mean healthcare costs (− $265,p= 0.309). There were no significant conditional effects of race seen among outcomes.ConclusionsThough non-English primary language was associated with a significantly different distribution of observable characteristics (including race, income quartile, and insurance type), after adjustment, non-English primary language was not associated with significant differential risk of adverse outcomes after bariatric surgery, and there were no significant conditional effects of race. As such, this study suggests that disparities in bariatric surgery by primary spoken language more likely related to access to care, or the pre- and post-hospital care continuum, rather than index hospitalization after surgery.Graphical abstract