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Baseline psychiatric diagnoses are associated with early readmissions and long hospital length of stay after bariatric surgery

机译：基线精神诊断与早期入伍和父亲手术后的早期住院长度有关

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Background The impact of well-controlled or historical psychiatric diagnoses in patients seeking bariatric surgery (BS) on perioperative outcomes is unclear. The primary objective of this study was to determine the impact of psychiatric diagnoses on hospital length of stay (LOS), 30-day readmission rates after BS, and post-operative weight loss outcomes. Methods Patients who underwent laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (LRNYGB) from 2014 to 2016 at a single academic institution were retrospectively reviewed. Baseline demographic data and psychiatric history including depression, anxiety, and/or bipolar disorder (DAB) were obtained from the electronic medical record. Hospital LOS, 30-day readmissions, and % excess body weight loss (%EBWL) were obtained on all patients and compared between DAB patients and those without any psychiatric history. Results During the study period, 354 patients were reviewed, of which 78% were female; 60% underwent LSG. The mean preoperative BMI was 48.9 ±8.4 m/kg~2. Major depression was the leading diagnosis (42%), and 13% had both depression and anxiety. The 30-day readmission rate was significantly higher than the control (10.5% vs. 3.7%, p = 0.02). Mean hospital LOS and the incidence of long hospital LOS (≥4 days) was not different between the groups, although within LSG patients, the incidence of long hospital LOS trended towards being higher for DAB patients (9.2% vs. 4%, p = 0.10). Patients with depression and anxiety had a higher incidence of long LOS (23.4% vs. 9.2%, p < 0.005). While 6-month %EBWL was significantly lower for DAB patients (41% vs. 46%, p = 0.004), 1-year weight loss outcomes were not different, even when adjusting for surgical procedure. Conclusion Patients with baseline or historical DAB had significantly higher early readmission rates, and those with multiple diagnoses were associated with a hospital LOS ≥ 4 days. Future studies should focus on elucidating the impact of psychiatric diagnoses on these quality metrics.
机译：背景技术对在围手术期结果寻求父亲手术（BS）的患者中，良好控制或历史精神病诊断的影响尚不清楚。本研究的主要目标是确定精神病诊断对医院住院时间（LOS），30天的入院率，以及在术后持续的减肥率。方法回顾性审查了2014年至2016年腹腔镜套管胃切除术（LSG）或RRNYGB）的患者。从电子病历中获得基线人口数据和包括抑郁，焦虑和/或双相障碍（DAB）的精神病史。在所有患者中获得医院洛杉矶，30天的阅览和百分比体重减轻（％EBWL），并在DAB患者和没有任何精神历史的情况下进行比较。研究期间，审查了354名患者，其中78％是女性; 60％接受了LSG。平均术前BMI为48.9±8.4 m / kg〜2。主要抑郁症是诊断的主要诊断（42％），13％患有抑郁和焦虑。 30天的阅约率明显高于对照（10.5％vs.3.7％，P = 0.02）。平均医院洛杉矶和长医院的发病率（≥4天）在群体之间没有差异，虽然在LSG患者内，长医院洛杉矶的发病率为DAB患者的趋势趋于较高（9.2％vs.4％，P = 0.10）。抑郁症和焦虑患者具有较高的LOS发病率（23.4％vs.9.2％，P <0.005）。虽然DAB患者6个月％EBWL显着降低了（41％对46％，P = 0.004），即使在调整外科手术时，1年的体重减轻结果也没有不同。结论患有基线或历史DAB的患者的早期入院率显着提高，具有多种诊断的患者与医院LOS≥4天相关。未来的研究应该侧重于阐明精神病诊断对这些质量指标的影响。

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