Utilization of intensive care resources in bariatric surgery

Obese patients occasionally require either elective or emergency critical care services following bariatric surgery. We describe this subgroup of patients. From July 1, 1991 to July 31, 2004, we performed 1,279 bariatric operations; 241 (19%) required admission to the surgical critical care service....

Full description

Saved in:

Bibliographic Details
Published in:	Obesity surgery Vol. 15; no. 9; pp. 1247 - 1251
Main Authors:	Cendán, Juan Carlos, Abu-aouf, Dolan, Gabrielli, Andrea, Caruso, Lawrence J, Rout, William Robert, Hocking, Michael P, Layon, A Joseph
Format:	Journal Article
Language:	English
Published:	United States Springer Nature B.V 01-10-2005
Subjects:	Anastomosis, Surgical - adverse effects Bariatric Surgery - adverse effects Body Mass Index Critical Care - utilization Emergencies Female Gastrointestinal surgery Hospitalization - economics Humans Intensive Care Units - utilization Male Obesity Obesity, Morbid - complications Obesity, Morbid - economics Obesity, Morbid - surgery Postoperative Complications - therapy Reoperation Respiratory Tract Diseases - etiology Respiratory Tract Diseases - therapy Thromboembolism - etiology Thromboembolism - therapy
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Obese patients occasionally require either elective or emergency critical care services following bariatric surgery. We describe this subgroup of patients. From July 1, 1991 to July 31, 2004, we performed 1,279 bariatric operations; 241 (19%) required admission to the surgical critical care service. We retrospectively reviewed medical records for gender, body mass index (BMI), age, whether the operation was initial or revisional, and whether critical care admission was elective or emergent. 3 complication clusters (thromboembolic, pulmonary, and anastomotic) were identified using discharge ICD-9 codes. The costs and length of stay of these subpopulations was calculated. Patients were on average 46+/-10 years old, with BMI 59+/-13. Critical care admission was emergent in 52.7% (n=127) of cases. Revisional cases did not differ from the initial cases in BMI (56.4 vs 59.2, P=0.42) and they were no more likely to require emergent critical care admission than initial cases (P=0.16). Revisional cases were hospitalized longer (27.2+/-25.6 vs 12.5+/-18.7 days, P=0.003); had higher total hospital costs (US$ 60,631+/-78,337 vs 27,697+/-52,351, P=0.025); and were more likely to die from their complications (revisional surgery mortality 6.5% vs 1.9% for initial surgery [P=0.002]). An increasing number of surgical revisions will likely accompany the recent increase in popularity of bariatric surgery. In our experience, these patients require significant critical care services, and have longer, complicated, and more costly hospitalizations.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0960-8923 1708-0428
DOI:	10.1381/096089205774512681