Evidence map›Paper›PMID 31004268›Full record

ArticleObesity surgery2019

Equivalent Peri-Operative Outcomes for Laparoscopic Roux-En-Y Gastric Bypass Patients Discharged on Post-Operative Day One.

Jarrod M Buzalewski, Mark E Mahan, Marcus Fluck, James Dove, Ryan D Horsley, David M Parker, Anthony T Petrick, Jon D Gabrielsen

Abstract read
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In one paragraph

Article in Obesity surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jarrod M BuzalewskiDepartment of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17822, USA. jbuzalewski@geisinger.edu.ORCID 0000-0002-1731-823X
Mark E MahanDepartment of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17822, USA.
Marcus FluckDepartment of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17822, USA.
James DoveDepartment of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17822, USA.
Ryan D HorsleyDepartment of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17822, USA.
David M ParkerDepartment of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17822, USA.
Anthony T PetrickDepartment of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17822, USA.
Jon D GabrielsenDepartment of Bariatric and Foregut Surgery, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17822, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious studies have evaluated the safety of post-operative day one (POD #1) discharge after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Few studies, however, have evaluated the impact of a standardized POD #1 discharge pathway on peri-operative outcomes. This study aims to evaluate peri-operative outcomes after implementation of an enhanced recovery pathway for RYGB patients.

methodsData from a prospectively maintained database identified 2,049 patients (pre-implementation n = 904; post-implementation n = 1,144) who underwent LRYGB between 2008 and 2016. The POD1 discharge pathway was implemented in July 2011. Patient demographics and outcomes before and after implementation of the POD1 pathway were compared using univariate analysis and propensity matching.

resultsA propensity-matched group of all patients (n = 714) and POD #1 candidates (n = 490) pre- and post-pathway implementation were analyzed. Successful POD #1 discharges were significantly increased after introduction of the pathway (54.3 vs 17.8%, p < 0.0001). The post-implementation groups demonstrated no differences in mortality, Emergency department (ED) visits, readmissions, reoperations, and major or minor complications.

conclusionsEarly discharge after bariatric surgery has a significant impact on the cost effectiveness of surgery, patient comfort, potential reduction of medical errors, and exposure to hospital-acquired infections. Our results demonstrate that a standardized POD #1 discharge pathway can be safely implemented and in turn, reduce hospital LOS without negatively affecting peri-operative morbidity, mortality, ED visit, readmission, or reoperation rates.

Indexed as

Gastric BypassPatient DischargeAdultFemaleHumansLaparoscopyMaleMatched-Pair AnalysisMiddle AgedPatient ReadmissionPostoperative ComplicationsReoperationEquivalent outcomesLRYGBPOD #1Post-operative day one

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.