The Standardized Postoperative Checklist for Bariatric Surgery; a Tool for Safe Early Discharge?
| Autor: | Stefanie R. van Mil, L Ulas Biter, Martin Dunkelgrun, Jan A Apers, Lucia E. Duinhouwer, Guido H. H. Mannaerts |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Sleeve gastrectomy Nausea Endocrinology Diabetes and Metabolism medicine.medical_treatment Bariatric Surgery Pilot Projects 030209 endocrinology & metabolism Morbidly obese 03 medical and health sciences Postoperative Complications 0302 clinical medicine Heart rate medicine Humans In patient Postoperative Period Early discharge Retrospective Studies Nutrition and Dietetics business.industry Middle Aged Reference Standards Patient Discharge Checklist Obesity Morbid Surgery Baseline characteristics Anesthesia Female 030211 gastroenterology & hepatology Patient Safety medicine.symptom business |
| Zdroj: | Obesity Surgery. 27:3102-3109 |
| ISSN: | 1708-0428 0960-8923 |
| DOI: | 10.1007/s11695-017-2746-y |
| Popis: | Morbidly obese patients are at higher risk of complications after surgery. In bariatric surgery, pre- and intra-operative checklists are commonly used to identify high-risk patients preoperatively, to decrease the number of postoperative complications. This pilot study evaluates the effect of a postoperative checklist in bariatric surgery, addressing regularly measured parameters, on the occurrence and early recognition of complications. An in-house developed postoperative checklist was used on the first postoperative day after bariatric surgery and included information on nausea, pain, temperature, heart rate, and laboratory markers. Complications were scored using the Clavien-Dindo (CD) classification, and three groups were formed: no complications (CD0), minor complications (CD1 and 2), and major complications (≥CD3a). Differences between groups were analyzed using nonparametric tests. Six hundred ninety-four subjects were included (79.5% female, age 42.6 ± 10.8 years, BMI 43.8 ± 5.8 kg/m2). Twenty-nine subjects developed major complications within 30 days postoperatively. There were no significant differences in baseline characteristics between groups. Subjects with major complications were less willing to be discharged due to complaints, compared to subjects with no or minor complications (14.8 vs. 3.6 and 4.6%, respectively) and had a higher decrease of hemoglobin level (0.8 vs. 0.6 and 0.65 mmol/l, respectively). The patient’s willingness for discharge, in combination with hemoglobin decrease, may be the best early predictors of major complications after bariatric surgery. This postoperative checklist may be an adequate instrument to identify patients who can be safely discharged home on the first postoperative day and thereby play a part in patient management after bariatric surgery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink