当天出院的胃旁路手术的安全性：荷兰肥胖症治疗审计的倾向得分匹配分析

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases Pub Date : 2024-12-01 DOI:10.1016/j.soard.2024.06.007

Suzanne C. Kleipool M.D. , Nini H. Jonkman Ph.D. , Pim W.J. van Rutte M.D., Ph.D. , Steve M.M. de Castro M.D., Ph.D. , Ruben N. van Veen M.D., Ph.D. , Dutch Audit for Treatment of Obesity (DATO) Research Group

{"title":"当天出院的胃旁路手术的安全性：荷兰肥胖症治疗审计的倾向得分匹配分析","authors":"Suzanne C. Kleipool M.D. , Nini H. Jonkman Ph.D. , Pim W.J. van Rutte M.D., Ph.D. , Steve M.M. de Castro M.D., Ph.D. , Ruben N. van Veen M.D., Ph.D. , Dutch Audit for Treatment of Obesity (DATO) Research Group","doi":"10.1016/j.soard.2024.06.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Bariatric surgery with same-day discharge (SDD) is becoming increasingly common. Nevertheless, there is limited data available comparing gastric bypass patients with SDD to those with overnight hospitalization.</div></div><div><h3>Objective</h3><div>The aim of this study was to investigate the short-term outcomes of gastric bypass with SDD compared to overnight hospitalization in The Netherlands.</div></div><div><h3>Setting</h3><div>Retrospective database study with the use of the Dutch national registry.</div></div><div><h3>Methods</h3><div>Patients who underwent gastric bypass surgery in 2022 were included and propensity score matching was performed to compare SDD with patients discharged on postoperative days (POD) 1-4. The primary outcome was the occurrence of severe complications within 30 days postoperative.</div></div><div><h3>Results</h3><div>A total of 775 SDD patients were matched with 1550 patients discharged on POD 1-4. The occurrence of severe complications was .9% in both groups (<em>P</em> = 1.000), and there were no significant differences in reoperations or mortality. A significant difference was observed in the readmission rate, with 3.9% in the SDD group compared to 1.6% in the other group (<em>P</em> = .001). A proportionally small, yet statistically significant difference favored the control group regarding anastomotic leakages (.6% versus 0%, <em>P</em> = .004) and unspecified surgical complications (1.4% versus .5%, <em>P</em> = .028).</div></div><div><h3>Conclusion</h3><div>Gastric bypass with SDD is safe, with no increased risk of short-term severe complications, reoperations, or mortality. However, SDD is associated with a higher 30-day readmission rate compared to patients who stay overnight in the hospital after surgery.</div></div>","PeriodicalId":49462,"journal":{"name":"Surgery for Obesity and Related Diseases","volume":"20 12","pages":"Pages 1226-1232"},"PeriodicalIF":3.5000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Safety of gastric bypass with same-day discharge: a propensity score-matched analysis of the Dutch Audit for treatment of Obesity\",\"authors\":\"Suzanne C. Kleipool M.D. , Nini H. Jonkman Ph.D. , Pim W.J. van Rutte M.D., Ph.D. , Steve M.M. de Castro M.D., Ph.D. , Ruben N. van Veen M.D., Ph.D. , Dutch Audit for Treatment of Obesity (DATO) Research Group\",\"doi\":\"10.1016/j.soard.2024.06.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Bariatric surgery with same-day discharge (SDD) is becoming increasingly common. Nevertheless, there is limited data available comparing gastric bypass patients with SDD to those with overnight hospitalization.</div></div><div><h3>Objective</h3><div>The aim of this study was to investigate the short-term outcomes of gastric bypass with SDD compared to overnight hospitalization in The Netherlands.</div></div><div><h3>Setting</h3><div>Retrospective database study with the use of the Dutch national registry.</div></div><div><h3>Methods</h3><div>Patients who underwent gastric bypass surgery in 2022 were included and propensity score matching was performed to compare SDD with patients discharged on postoperative days (POD) 1-4. The primary outcome was the occurrence of severe complications within 30 days postoperative.</div></div><div><h3>Results</h3><div>A total of 775 SDD patients were matched with 1550 patients discharged on POD 1-4. The occurrence of severe complications was .9% in both groups (<em>P</em> = 1.000), and there were no significant differences in reoperations or mortality. A significant difference was observed in the readmission rate, with 3.9% in the SDD group compared to 1.6% in the other group (<em>P</em> = .001). A proportionally small, yet statistically significant difference favored the control group regarding anastomotic leakages (.6% versus 0%, <em>P</em> = .004) and unspecified surgical complications (1.4% versus .5%, <em>P</em> = .028).</div></div><div><h3>Conclusion</h3><div>Gastric bypass with SDD is safe, with no increased risk of short-term severe complications, reoperations, or mortality. However, SDD is associated with a higher 30-day readmission rate compared to patients who stay overnight in the hospital after surgery.</div></div>\",\"PeriodicalId\":49462,\"journal\":{\"name\":\"Surgery for Obesity and Related Diseases\",\"volume\":\"20 12\",\"pages\":\"Pages 1226-1232\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery for Obesity and Related Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1550728924006750\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery for Obesity and Related Diseases","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1550728924006750","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

摘要

背景：减肥手术当日出院（SDD）正变得越来越普遍。然而，比较胃旁路术合并SDD患者与过夜住院患者的数据有限。目的：本研究的目的是调查荷兰胃分流术合并SDD与过夜住院治疗的短期结果。背景：采用荷兰国家登记处的回顾性数据库研究。方法纳入2022年行胃分流术的患者，进行倾向评分匹配，比较SDD与术后1-4天出院的患者。主要观察指标为术后30天内严重并发症的发生情况。结果775例SDD患者与1550例POD 1-4出院患者匹配。两组严重并发症发生率均为0.9% (P = 1.000)，再手术率和死亡率无显著差异。SDD组的再入院率为3.9%，而另一组为1.6%，差异有统计学意义（P = 0.001）。在吻合口瘘方面，对照组的差异虽小，但在统计学上有显著意义。6%对0%，P = 0.004)和未明确的手术并发症（1.4%对0.5%,P = 0.028）。结论SDD胃旁路术是安全的，没有增加短期严重并发症、再手术或死亡的风险。然而，与术后住院过夜的患者相比，SDD与更高的30天再入院率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Safety of gastric bypass with same-day discharge: a propensity score-matched analysis of the Dutch Audit for treatment of Obesity

Background

Bariatric surgery with same-day discharge (SDD) is becoming increasingly common. Nevertheless, there is limited data available comparing gastric bypass patients with SDD to those with overnight hospitalization.

Objective

The aim of this study was to investigate the short-term outcomes of gastric bypass with SDD compared to overnight hospitalization in The Netherlands.

Setting

Retrospective database study with the use of the Dutch national registry.

Methods

Patients who underwent gastric bypass surgery in 2022 were included and propensity score matching was performed to compare SDD with patients discharged on postoperative days (POD) 1-4. The primary outcome was the occurrence of severe complications within 30 days postoperative.

Results

A total of 775 SDD patients were matched with 1550 patients discharged on POD 1-4. The occurrence of severe complications was .9% in both groups (P = 1.000), and there were no significant differences in reoperations or mortality. A significant difference was observed in the readmission rate, with 3.9% in the SDD group compared to 1.6% in the other group (P = .001). A proportionally small, yet statistically significant difference favored the control group regarding anastomotic leakages (.6% versus 0%, P = .004) and unspecified surgical complications (1.4% versus .5%, P = .028).

Conclusion

Gastric bypass with SDD is safe, with no increased risk of short-term severe complications, reoperations, or mortality. However, SDD is associated with a higher 30-day readmission rate compared to patients who stay overnight in the hospital after surgery.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Surgery for Obesity and Related Diseases 医学-外科

CiteScore

6.70

自引率

12.90%

发文量

570

审稿时长

56 days

期刊介绍： Surgery for Obesity and Related Diseases (SOARD), The Official Journal of the American Society for Metabolic and Bariatric Surgery (ASMBS) and the Brazilian Society for Bariatric Surgery, is an international journal devoted to the publication of peer-reviewed manuscripts of the highest quality with objective data regarding techniques for the treatment of severe obesity. Articles document the effects of surgically induced weight loss on obesity physiological, psychiatric and social co-morbidities.