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Length of stay and impact on readmission rates after laparoscopic gastric bypass.
Surg Obes Relat Dis. 2006 Jul-Aug; 2(4):435-9.SO

Abstract

BACKGROUND

A decreased length of stay (LOS) is one of the many advantages of laparoscopic over open Roux-en-Y gastric bypass for the treatment of morbid obesity. However, the mean LOS after laparoscopic gastric bypass (LGB) ranges from 1.8 to 4.5 days. In addition, the LOS has tended to improve as bariatric programs have matured. With the use of a standardized perioperative care plan, we studied the effects of LOS on readmission rates in patients undergoing LGB in a new minimally invasive bariatric surgery program.

METHODS

All patients undergoing LGB between September 20, 2001 and April 5, 2004 were entered into a standardized perioperative care plan. All patient outcomes were entered into a prospective database. The discharge criteria included adequate oral intake and adequate pain control on oral medication. The reasons for patients staying >2 days were analyzed and documented.

RESULTS

A total 250 patients underwent LGB. Of these, 212 patients (84.8%) were discharged on postoperative day 2. The most common reason for a LOS >2 days was bleeding (42.1%), followed by nausea (26.3%), inadequate pain control on oral medication (15.8%), and various other reasons (15.8%). The mean LOS did not change with time (P = .19). Readmission within 30 days was significantly less in patients discharged by day 2 (1.9% versus 13.1%, P = .005).

CONCLUSIONS

The LOS remained constant as our program matured. The vast majority of patients undergoing LGB who have an uncomplicated postoperative course were safely discharged home on postoperative day 2. Patients staying >2 days were more likely to be readmitted within 30 days of discharge.

Authors+Show Affiliations

Gundersen Lutheran Medical Center, La Crosse, WI 54601, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16925375

Citation

Baker, Matthew T., et al. "Length of Stay and Impact On Readmission Rates After Laparoscopic Gastric Bypass." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 2, no. 4, 2006, pp. 435-9.
Baker MT, Lara MD, Larson CJ, et al. Length of stay and impact on readmission rates after laparoscopic gastric bypass. Surg Obes Relat Dis. 2006;2(4):435-9.
Baker, M. T., Lara, M. D., Larson, C. J., Lambert, P. J., Mathiason, M. A., & Kothari, S. N. (2006). Length of stay and impact on readmission rates after laparoscopic gastric bypass. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 2(4), 435-9.
Baker MT, et al. Length of Stay and Impact On Readmission Rates After Laparoscopic Gastric Bypass. Surg Obes Relat Dis. 2006;2(4):435-9. PubMed PMID: 16925375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Length of stay and impact on readmission rates after laparoscopic gastric bypass. AU - Baker,Matthew T, AU - Lara,Michael D, AU - Larson,Christopher J, AU - Lambert,Pamela J, AU - Mathiason,Michelle A, AU - Kothari,Shanu N, PY - 2005/11/22/received PY - 2006/01/31/revised PY - 2006/02/07/accepted PY - 2006/8/24/pubmed PY - 2006/9/27/medline PY - 2006/8/24/entrez SP - 435 EP - 9 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 2 IS - 4 N2 - BACKGROUND: A decreased length of stay (LOS) is one of the many advantages of laparoscopic over open Roux-en-Y gastric bypass for the treatment of morbid obesity. However, the mean LOS after laparoscopic gastric bypass (LGB) ranges from 1.8 to 4.5 days. In addition, the LOS has tended to improve as bariatric programs have matured. With the use of a standardized perioperative care plan, we studied the effects of LOS on readmission rates in patients undergoing LGB in a new minimally invasive bariatric surgery program. METHODS: All patients undergoing LGB between September 20, 2001 and April 5, 2004 were entered into a standardized perioperative care plan. All patient outcomes were entered into a prospective database. The discharge criteria included adequate oral intake and adequate pain control on oral medication. The reasons for patients staying >2 days were analyzed and documented. RESULTS: A total 250 patients underwent LGB. Of these, 212 patients (84.8%) were discharged on postoperative day 2. The most common reason for a LOS >2 days was bleeding (42.1%), followed by nausea (26.3%), inadequate pain control on oral medication (15.8%), and various other reasons (15.8%). The mean LOS did not change with time (P = .19). Readmission within 30 days was significantly less in patients discharged by day 2 (1.9% versus 13.1%, P = .005). CONCLUSIONS: The LOS remained constant as our program matured. The vast majority of patients undergoing LGB who have an uncomplicated postoperative course were safely discharged home on postoperative day 2. Patients staying >2 days were more likely to be readmitted within 30 days of discharge. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/16925375/Length_of_stay_and_impact_on_readmission_rates_after_laparoscopic_gastric_bypass_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(06)00125-0 DB - PRIME DP - Unbound Medicine ER -