Cross-sectional study of variables associated with length of stay and ICU need in open Roux-En-Y gastric bypass surgery for morbid obese patients: an exploratory analysis based on the Public Health System administrative database (Datasus) in Brazil.
Obes Surg
; 22(12): 1810-7, 2012 Dec.
Article
em En
| MEDLINE
| ID: mdl-22700422
BACKGROUND: This is an exploratory analysis of potential variables associated with open Roux-en-Y gastric bypass (RYGB) surgery hospitalization resource use pattern. METHODS: Cross-sectional study based on an administrative database (DATASUS) records. Inclusion criteria were adult patients undergoing RYGB between Jan/2008 and Jun/2011. Dependent variables were length of stay (LoS) and ICU need. Independent variables were: gender, age, region, hospital volume, surgery at certified center of excellence (CoE) by the Surgical Review Corporation (SRC), teaching hospital, and year of hospitalization. Univariate and multivariate analysis (logistic regression for ICU need and linear regression for length of stay) were performed. RESULTS: Data from 13,069 surgeries were analyzed. In crude analysis, hospital volume was the most impactful variable associated with log-transformed LoS (1.312 ± 0.302 high volume vs. 1.670 ± 0.581 low volume, p < 0.001), whereas for ICU need it was certified CoE (odds ratio (OR), 0.016; 95% confidence interval (CI), 0.010-0.026). After adjustment by logistic regression, certified CoE remained as the strongest predictor of ICU need (OR, 0.011; 95% CI, 0.007-0.018), followed by hospital volume (OR, 3.096; 95% CI, 2.861-3.350). Age group, male gender, and teaching hospital were also significantly associated (p < 0.001). For log-transformed LoS, final model includes hospital volume (coefficient, -0.223; 95% CI, -0.250 to -0.196) and teaching hospital (coefficient, 0.375; 95% CI, 0.351-0.398). Region of Brazil was not associated with any of the outcomes. CONCLUSIONS: High-volume hospital was the strongest predictor for shorter LoS, whereas SRC certification was the strongest predictor of lower ICU need. Public health policies targeting an increase of efficiency and patient access to the procedure should take into account these results.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Obesidade Mórbida
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Derivação Gástrica
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Unidades de Terapia Intensiva
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Tempo de Internação
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Obes Surg
Assunto da revista:
METABOLISMO
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
Estados Unidos