Factors implicated in discharge disposition following elective bariatric surgery.
Bariatric surgery
Discharge destination
Discharge facility
Gastric bypass
Rehab
Sleeve gastrectomy
Journal
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
28
07
2020
revised:
17
08
2020
accepted:
19
08
2020
pubmed:
9
10
2020
medline:
25
5
2021
entrez:
8
10
2020
Statut:
ppublish
Résumé
Current bariatric surgery studies have focused on traditional outcomes such as mortality and morbidity and have thus far have neglected an important marker of surgical care- discharge destination. The aim of this study was to 1) characterize the prevalence of and clinical characteristics of patients who undergo bariatric surgery with respect to discharge disposition and to 2) evaluate factors which predict alternate care facility (ACF) discharge. Participating Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) centers. Data was extracted from the MBSAQIP data registry from 2015 to 2018. All primary Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) procedures were included while prior revisional surgeries and emergency surgeries were excluded. Our primary objective was to characterize the prevalence of and clinical characteristics of patients who undergo bariatric surgery and are discharged to an alternate care facility (ACF). Our secondary outcome was to identify predictors of discharge to an ACF using multivariable logistic regression modeling. Most patients (n = 588,256; 99.6%) were discharged home while only a small proportion were discharged to an ACF (n = 1502; .4%). Patients discharged to an ACF were older (51.5 ± 13.5 yr versus 44.4 ± 12.0 yr; P < .0001), of increased body mass index (49.7 ± 11.9 kg/m Impaired functional status was the single greatest independent preoperative predictor of ACF discharge, providing evidence against the current use of a strict age cut-off criteria and support for implementation of a more patient-centered functional approach in selection of surgical candidates.
Sections du résumé
BACKGROUND
BACKGROUND
Current bariatric surgery studies have focused on traditional outcomes such as mortality and morbidity and have thus far have neglected an important marker of surgical care- discharge destination.
OBJECTIVES
OBJECTIVE
The aim of this study was to 1) characterize the prevalence of and clinical characteristics of patients who undergo bariatric surgery with respect to discharge disposition and to 2) evaluate factors which predict alternate care facility (ACF) discharge.
SETTING
METHODS
Participating Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) centers.
METHODS
METHODS
Data was extracted from the MBSAQIP data registry from 2015 to 2018. All primary Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) procedures were included while prior revisional surgeries and emergency surgeries were excluded. Our primary objective was to characterize the prevalence of and clinical characteristics of patients who undergo bariatric surgery and are discharged to an alternate care facility (ACF). Our secondary outcome was to identify predictors of discharge to an ACF using multivariable logistic regression modeling.
RESULTS
RESULTS
Most patients (n = 588,256; 99.6%) were discharged home while only a small proportion were discharged to an ACF (n = 1502; .4%). Patients discharged to an ACF were older (51.5 ± 13.5 yr versus 44.4 ± 12.0 yr; P < .0001), of increased body mass index (49.7 ± 11.9 kg/m
CONCLUSION
CONCLUSIONS
Impaired functional status was the single greatest independent preoperative predictor of ACF discharge, providing evidence against the current use of a strict age cut-off criteria and support for implementation of a more patient-centered functional approach in selection of surgical candidates.
Identifiants
pubmed: 33028489
pii: S1550-7289(20)30498-6
doi: 10.1016/j.soard.2020.08.031
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
104-111Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.