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Risk of Delayed Discharge and Reoperation of Gastric Bypass Patients with Psychiatric Comorbidity-a Nationwide Cohort Study.

Abstract：

BACKGROUND:Gastric bypass (GBP) surgery is considered a safe and effective treatment for obesity. However, there is uncertainty regarding the impact of preexisting psychiatric comorbidity on GBP complications. We have investigated whether a psychiatric diagnosis before GBP surgery is associated with delayed discharge (the odds of being in the 90th percentile of length of stay) and rate of reoperation in a nationwide Swedish cohort. METHODS:Patients undergoing GBP surgery during 2008-2012 were identified and followed up through the National Patient Register and the Prescribed Drug Register. Logistic regression models were fitted to the studied outcomes. RESULTS:Among the 22,539 patients identified, a prior diagnosis of bipolar disorder, schizophrenia, depression, neurotic disorders, ADHD (attention deficit hyperactivity disorder), substance use disorder, eating disorder, personality disorder, or self-harm since 1997 (n = 9480) was found to be associated with delayed discharge after GBP surgery (odds ratio [OR] = 1.47, confidence interval [CI] 1.34-1.62), especially in patients with psychiatric hospitalization exceeding 1 week in the 2 years preceding GBP surgery (OR = 2.06, CI 1.30-3.28), compared with those not hospitalized within psychiatry. Likewise, patients with a prior psychiatric diagnosis were more likely to be reoperated within 30 days (OR = 1.25, CI 1.11-1.41), with twice the likelihood OR 2.23 (CI 1.26-3.92) for patients with psychiatric hospitalization of up to a week in the 2 years preceding GBP surgery, compared with patients who had not been hospitalized within psychiatry. CONCLUSIONS:A psychiatric diagnosis before GBP surgery was associated with delayed discharge and increased likelihood of reoperation within 30 days. Patients with a prior psychiatric diagnosis may, therefore, need additional attention and support.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Lagerros YT,Brandt L,Sundbom M,Hedberg J,Bodén R

doi

10.1007/s11695-020-04483-7

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

2511-2518

issue

eissn

0960-8923

issn

1708-0428

pii

10.1007/s11695-020-04483-7

journal_volume

pub_type

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Risk of Delayed Discharge and Reoperation of Gastric Bypass Patients with Psychiatric Comorbidity-a Nationwide Cohort Study.