Characterization of urgent versus nonurgent early readmissions (<30 days) following primary bariatric surgery: a single-institution experience
Characterization of urgent versus nonurgent early readmissions (<30 days) following primary bariatric surgery: a single-institution experience
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DOI：
10.1016/j.soard.2021.01.042
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发表时间：
2021-04-28
影响因子：
3.1
通讯作者：
Noria, Sabrena F.
中科院分区：
文献类型：
--
作者：
Jalilvand, Anahita;Levene, Katelyn A.;Noria, Sabrena F.
背景资料：关于减肥手术（BS）后早期术后再入院的研究将再入院作为一个单一实体进行了研究，无论是否紧急。降低非紧急再入院率的策略将减少不必要的医院utilization.Objectives：确定预测因素的紧急再入院率（UR）与非紧急再入院率（努尔）在30天后BS.Setting：单一学术institution.Methods：患者接受原发性BS超过2年（n = 589）进行了回顾性分析。比较了再入院患者（按紧急程度分层）和未再入院患者的基线人口统计学、医疗和住院数据。使用P值2术后并发症（分别为46%和17.0%; P = 0.003）与努尔相比的变量创建UR和努尔的多变量回归模型。努尔的独立预测因素包括公共保险（比值比[OR] = 3.7; 95%置信区间[CI]，1.17-11.67; P = 0.03），年龄较小（OR = 1.05; 95%CI，1-1.01; P = 0.04），而UR是由LOS独立预测的（OR = 1.3; 95%CI，1.04-1.5; P = .02）。结论：公共保险似乎与BS后的URs相关，而LOS预测BS后的URs。这表明，根据紧急程度重新入院的情况存在重要的二分法，这对有针对性的质量举措具有重要影响。(C)2021年美国肥胖外科学会。爱思唯尔公司出版All rights reserved.
Background: Studies on early postoperative readmissions after bariatric surgery (BS) have examined readmissions as a single entity, regardless of urgency. Strategies to lower nonurgent readmissions would reduce unnecessary hospital utilization.Objectives: To identify predictors of urgent readmissions (UR) versus nonurgent readmissions (NUR) at 30 days post-BS.Setting: Single academic institution.Methods: Patients undergoing primary BS over 2 years (n = 589) were retrospectively reviewed. Baseline demographic, medical, and hospitalization data were compared between readmitted patients, stratified by urgency, and nonreadmitted patients. Multivariate regression models of UR and NUR were created using variables with a P value 2 postoperative complications (46% versus 17.0%, respectively; P = .003) compared with those with an NUR. Independent predictors of NUR included public insurance (odds ratio [OR] = 3.7; 95% confidence interval [CI], 1.17-11.67; P = .03), younger age (OR = 1.05; 95% CI, 1-1.01; P = .04), and female sex, while URs were independently predicted by LOS (OR = 1.3; 95% CI, 1.04-1.5; P = .02).Conclusions: Public insurance appears to be associated with NURs, while LOS predicts URs after BS. This suggests an important dichotomy within readmissions based on urgency, which has important implications for targeted quality initiatives. (C) 2021 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.