Evidence map›Paper›PMID 39214879›Full record

ArticleSurgical endoscopy2024

Safety and factors associated with early discharge in revisional laparoscopic Roux-en-Y gastric bypass: analysis of the MBSAQIP database.

Qais AbuHasan, Maya Hunt, Louis Massoud, Charles P Burney, Amy L Holmstrom, Tarik K Yuce, Dimitrios Stefanidis

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In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 3 pooled it
–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

4 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. 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

7 authors.

Qais AbuHasanDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, Indianapolis, IN, 46202, USA.ORCID 0000-0002-9055-8344
Maya HuntDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, Indianapolis, IN, 46202, USA.
Louis MassoudDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, Indianapolis, IN, 46202, USA.
Charles P BurneyDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, Indianapolis, IN, 46202, USA.
Amy L HolmstromDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, Indianapolis, IN, 46202, USA.
Tarik K YuceDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, Indianapolis, IN, 46202, USA.
Dimitrios StefanidisDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, Indianapolis, IN, 46202, USA. dimstefa@iu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImprovements in bariatric surgery outcomes have prompted policy initiatives that explore shifting bariatric surgery toward outpatient procedures. While the safety of early discharge after primary laparoscopic Roux-en-Y gastric bypass (LRYGB) has been reported, its safety for revisional LRYGB remains uncertain. Our study aimed to investigate the safety and patient factors associated with early discharge in patients undergoing revisional LRYGB compared with primary LRYGB.

methodsWe identified adult patients who underwent primary and revisional LRYGB from 2020 to 2022 in the MBSAQIP database. Patients discharged early, i.e., same-day discharge (SDD) and next-day discharge (NDD) were compared to inpatients. Outcomes included 30-day complications (minor = Clavien-Dindo 1-2; major = Clavien-Dindo 3-4), mortality, readmissions, and reoperations. Multivariable logistic regression models adjusting for patient demographics, comorbidities, and operative time were fitted to assess the study outcomes.

resultsSDD rate was similar after primary (3,422/137,406; 2.5%) and revisional LRYGB (781/32,721; 2.4%), while NDD rate was higher in primary LRYGB (59.8% vs 54.7%, respectively; p < 0.001). SDD patients had lower odds of major complications compared to inpatients following primary (2% vs 7%, aOR: 0.30, 95%CI 0.24-0.38) and revisional LRYGB (3.7% vs 9.3%, aOR: 0.43, 95%CI 0.29-0.62, respectively). NDD patients had similarly lower odds of morbidity outcomes. ASA Classification IV/V was associated with lower odds of SDD compared to Class I/II (Primary: 0.9% vs. 3%, aOR: 0.61, 95% CI 0.48-0.78; Revisions: 0.9% vs. 3%, aOR: 0.24, 95%CI 0.10-0.55).

conclusionEarly discharge after revisional LRYGB, particularly after an overnight stay, can be accomplished safely in carefully selected patients. However, SDD rates remain low limiting its safety assessment. Further, almost half of the patients stay more than 48 h in the hospital suggesting that policy initiatives toward outpatient management after bariatric surgery may be inappropriate for this patient population.

Indexed as

Gastric BypassLaparoscopyObesity, MorbidPatient DischargePostoperative ComplicationsReoperationAdultDatabases, FactualFemaleHumansLength of StayMaleMiddle AgedPatient ReadmissionRetrospective StudiesBariatric surgeryEarly dischargeGastric bypassOutpatientRevision surgery

Identifiers

PMID39214879

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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.