학술논문
Gender, BMI, Patient Comorbidities, and Hospital Characteristics Influence 30-Day Readmission Following Vertical Sleeve Gastrectomy.
Document Type
Academic Journal
Author
Dubchuk C; Department of Surgery, Division of Vascular Surgery and Endovascular Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.; Afifi AM; Department of Surgery, Division of Vascular Surgery and Endovascular Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.; Chawla K; Department of Surgery, Division of Vascular Surgery and Endovascular Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.; Nasif A; Department of Surgery, Division of Vascular Surgery and Endovascular Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.; Ren G; Department of Surgery, Division of Vascular Surgery and Endovascular Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.; Osman MF; Department of Surgery, Division of Vascular Surgery and Endovascular Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.; Sferra J; Department of Surgery, Division of Vascular Surgery and Endovascular Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.; Pannell S; Department of Surgery, Division of Vascular Surgery and Endovascular Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.; Nazzal M; Department of Surgery, Division of Vascular Surgery and Endovascular Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA. munier.nazzal@utoledo.edu.
Source
Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 9106714 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1708-0428 (Electronic) Linking ISSN: 09608923 NLM ISO Abbreviation: Obes Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: Obesity impacts 300 million people worldwide and the number continues to increase. Laparoscopic sleeve gastrectomy (LSG) is one of several bariatric procedures offered to help these individuals achieve a healthier life. Here, we report 30-day readmission rates and risk factors for readmission after gastrectomy.
Materials and Methods: We used the US Healthcare Utilization Project's Nationwide Readmission Database (NRD) from 2016 to 2019 for patients who underwent laparoscopic gastrectomy and evaluated 30-day readmission rates, comparing readmitted patients to non-readmitted patients. Confounder adjusted and unadjusted analysis were proceeded to the potential factors.
Results: The study population consisted of 235,563 patients, with a 3.0% readmission rate. Factors associated with a higher readmission rate included older age, male gender, higher BMI, Medicare as the primary payer, longer length of stay, higher total charge, higher Charlson Comorbidity Index, higher Elixhauser-Comorbidity Index, lower household income, non-elective admission type, and non-routine disposition. Additionally, larger hospital bed size, and private, invest-own hospital ownership were associated with higher readmission rates. After adjusting for confounders, several comorbidities and complications were found to be significantly associated with readmission, including ileus, abnormal weight loss, postprocedural complications of digestive system, acute posthemorrhagic anemia, and history of pulmonary embolism (all p < 0.001).
Conclusions: Patient characteristics including age, BMI, and payment source, as well as hospital characteristics, can impact the 30-day readmission after LSG. Such factors should be considered by CMS when deciding on penalties related to readmission.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Materials and Methods: We used the US Healthcare Utilization Project's Nationwide Readmission Database (NRD) from 2016 to 2019 for patients who underwent laparoscopic gastrectomy and evaluated 30-day readmission rates, comparing readmitted patients to non-readmitted patients. Confounder adjusted and unadjusted analysis were proceeded to the potential factors.
Results: The study population consisted of 235,563 patients, with a 3.0% readmission rate. Factors associated with a higher readmission rate included older age, male gender, higher BMI, Medicare as the primary payer, longer length of stay, higher total charge, higher Charlson Comorbidity Index, higher Elixhauser-Comorbidity Index, lower household income, non-elective admission type, and non-routine disposition. Additionally, larger hospital bed size, and private, invest-own hospital ownership were associated with higher readmission rates. After adjusting for confounders, several comorbidities and complications were found to be significantly associated with readmission, including ileus, abnormal weight loss, postprocedural complications of digestive system, acute posthemorrhagic anemia, and history of pulmonary embolism (all p < 0.001).
Conclusions: Patient characteristics including age, BMI, and payment source, as well as hospital characteristics, can impact the 30-day readmission after LSG. Such factors should be considered by CMS when deciding on penalties related to readmission.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)