Factors associated with length of stay in intensive care after bariatric surgery

Dvir Froylich, Ricard Corcelles, Matthew Davis, Mena Boules, Christopher R. Daigle, Philip R. Schauer, Stacy A. Brethauer

Research output: Contribution to journalArticle

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Abstract

Background Although uncommon, admission to the intensive care unit (ICU) after bariatric surgery may be necessary. This study evaluates characteristics of bariatric surgery patients that are admitted to the ICU, and identifies possible risk factors for increased ICU length of stay (LOS). Setting Academic hospital, United States. Methods A retrospective review of all ICU admissions after bariatric surgery from 2006 to 2013 was performed. Demographic characteristics and perioperative data were extracted, and risk factors for the LOS and mortality in the ICU were analyzed. Results In total, 124 out of 4398 (2.8%) patients were admitted to the ICU after bariatric surgery. The mean age of these patients was 52.7±11.8 years and included 79 female patients (64%). There were 19 nonemergent or planned admissions (15.3%) and 105 unplanned admissions (84.7%). Mean body mass index was 47.8±12.2 kg/m2, and mean American Society of Anesthesiology (ASA) score was 3.1±0.6. Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding were performed in 80 (65%), 18 (15%), and 6 (5%) patients, respectively. Revisional procedures were performed in 15 (12%) patients. Respiratory failure was the most common cause for admission, occurring in 35 (28.2%) patients. The most common surgical complications requiring ICU admission were bleeding (n = 27) and anastomotic leak (n = 21). Mean ICU LOS was 6.0±9.6 (1−65) days. Mortality occurred in 5 (4.0%) patients. Based on univariate analysis, risk factors associated with ICU LOS were conversion from laparoscopic to open approach, anastomotic leak, time from operation to ICU admission, and reoperation. Higher ASA score was a significant risk factor for mortality. Conclusion ICU admission after bariatric surgery is uncommon but is associated with a significantly increased mortality. Anastomotic leak, conversions, time from operation to ICU admission, and reoperation have the greatest impact in determining the LOS in the ICU after bariatric surgery.

Original languageEnglish (US)
Pages (from-to)1391-1396
Number of pages6
JournalSurgery for Obesity and Related Diseases
Volume12
Issue number7
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

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Bariatric Surgery
Critical Care
Intensive Care Units
Length of Stay
Anastomotic Leak
Anesthesiology
Mortality
Reoperation
Gastric Bypass
Gastrectomy
Respiratory Insufficiency
Stomach
Body Mass Index

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Froylich, D., Corcelles, R., Davis, M., Boules, M., Daigle, C. R., Schauer, P. R., & Brethauer, S. A. (2016). Factors associated with length of stay in intensive care after bariatric surgery. Surgery for Obesity and Related Diseases, 12(7), 1391-1396. https://doi.org/10.1016/j.soard.2015.11.031

Factors associated with length of stay in intensive care after bariatric surgery. / Froylich, Dvir; Corcelles, Ricard; Davis, Matthew; Boules, Mena; Daigle, Christopher R.; Schauer, Philip R.; Brethauer, Stacy A.

In: Surgery for Obesity and Related Diseases, Vol. 12, No. 7, 01.08.2016, p. 1391-1396.

Research output: Contribution to journalArticle

Froylich, D, Corcelles, R, Davis, M, Boules, M, Daigle, CR, Schauer, PR & Brethauer, SA 2016, 'Factors associated with length of stay in intensive care after bariatric surgery', Surgery for Obesity and Related Diseases, vol. 12, no. 7, pp. 1391-1396. https://doi.org/10.1016/j.soard.2015.11.031
Froylich, Dvir ; Corcelles, Ricard ; Davis, Matthew ; Boules, Mena ; Daigle, Christopher R. ; Schauer, Philip R. ; Brethauer, Stacy A. / Factors associated with length of stay in intensive care after bariatric surgery. In: Surgery for Obesity and Related Diseases. 2016 ; Vol. 12, No. 7. pp. 1391-1396.
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abstract = "Background Although uncommon, admission to the intensive care unit (ICU) after bariatric surgery may be necessary. This study evaluates characteristics of bariatric surgery patients that are admitted to the ICU, and identifies possible risk factors for increased ICU length of stay (LOS). Setting Academic hospital, United States. Methods A retrospective review of all ICU admissions after bariatric surgery from 2006 to 2013 was performed. Demographic characteristics and perioperative data were extracted, and risk factors for the LOS and mortality in the ICU were analyzed. Results In total, 124 out of 4398 (2.8{\%}) patients were admitted to the ICU after bariatric surgery. The mean age of these patients was 52.7±11.8 years and included 79 female patients (64{\%}). There were 19 nonemergent or planned admissions (15.3{\%}) and 105 unplanned admissions (84.7{\%}). Mean body mass index was 47.8±12.2 kg/m2, and mean American Society of Anesthesiology (ASA) score was 3.1±0.6. Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding were performed in 80 (65{\%}), 18 (15{\%}), and 6 (5{\%}) patients, respectively. Revisional procedures were performed in 15 (12{\%}) patients. Respiratory failure was the most common cause for admission, occurring in 35 (28.2{\%}) patients. The most common surgical complications requiring ICU admission were bleeding (n = 27) and anastomotic leak (n = 21). Mean ICU LOS was 6.0±9.6 (1−65) days. Mortality occurred in 5 (4.0{\%}) patients. Based on univariate analysis, risk factors associated with ICU LOS were conversion from laparoscopic to open approach, anastomotic leak, time from operation to ICU admission, and reoperation. Higher ASA score was a significant risk factor for mortality. Conclusion ICU admission after bariatric surgery is uncommon but is associated with a significantly increased mortality. Anastomotic leak, conversions, time from operation to ICU admission, and reoperation have the greatest impact in determining the LOS in the ICU after bariatric surgery.",
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AU - Froylich, Dvir

AU - Corcelles, Ricard

AU - Davis, Matthew

AU - Boules, Mena

AU - Daigle, Christopher R.

AU - Schauer, Philip R.

AU - Brethauer, Stacy A.

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N2 - Background Although uncommon, admission to the intensive care unit (ICU) after bariatric surgery may be necessary. This study evaluates characteristics of bariatric surgery patients that are admitted to the ICU, and identifies possible risk factors for increased ICU length of stay (LOS). Setting Academic hospital, United States. Methods A retrospective review of all ICU admissions after bariatric surgery from 2006 to 2013 was performed. Demographic characteristics and perioperative data were extracted, and risk factors for the LOS and mortality in the ICU were analyzed. Results In total, 124 out of 4398 (2.8%) patients were admitted to the ICU after bariatric surgery. The mean age of these patients was 52.7±11.8 years and included 79 female patients (64%). There were 19 nonemergent or planned admissions (15.3%) and 105 unplanned admissions (84.7%). Mean body mass index was 47.8±12.2 kg/m2, and mean American Society of Anesthesiology (ASA) score was 3.1±0.6. Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding were performed in 80 (65%), 18 (15%), and 6 (5%) patients, respectively. Revisional procedures were performed in 15 (12%) patients. Respiratory failure was the most common cause for admission, occurring in 35 (28.2%) patients. The most common surgical complications requiring ICU admission were bleeding (n = 27) and anastomotic leak (n = 21). Mean ICU LOS was 6.0±9.6 (1−65) days. Mortality occurred in 5 (4.0%) patients. Based on univariate analysis, risk factors associated with ICU LOS were conversion from laparoscopic to open approach, anastomotic leak, time from operation to ICU admission, and reoperation. Higher ASA score was a significant risk factor for mortality. Conclusion ICU admission after bariatric surgery is uncommon but is associated with a significantly increased mortality. Anastomotic leak, conversions, time from operation to ICU admission, and reoperation have the greatest impact in determining the LOS in the ICU after bariatric surgery.

AB - Background Although uncommon, admission to the intensive care unit (ICU) after bariatric surgery may be necessary. This study evaluates characteristics of bariatric surgery patients that are admitted to the ICU, and identifies possible risk factors for increased ICU length of stay (LOS). Setting Academic hospital, United States. Methods A retrospective review of all ICU admissions after bariatric surgery from 2006 to 2013 was performed. Demographic characteristics and perioperative data were extracted, and risk factors for the LOS and mortality in the ICU were analyzed. Results In total, 124 out of 4398 (2.8%) patients were admitted to the ICU after bariatric surgery. The mean age of these patients was 52.7±11.8 years and included 79 female patients (64%). There were 19 nonemergent or planned admissions (15.3%) and 105 unplanned admissions (84.7%). Mean body mass index was 47.8±12.2 kg/m2, and mean American Society of Anesthesiology (ASA) score was 3.1±0.6. Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding were performed in 80 (65%), 18 (15%), and 6 (5%) patients, respectively. Revisional procedures were performed in 15 (12%) patients. Respiratory failure was the most common cause for admission, occurring in 35 (28.2%) patients. The most common surgical complications requiring ICU admission were bleeding (n = 27) and anastomotic leak (n = 21). Mean ICU LOS was 6.0±9.6 (1−65) days. Mortality occurred in 5 (4.0%) patients. Based on univariate analysis, risk factors associated with ICU LOS were conversion from laparoscopic to open approach, anastomotic leak, time from operation to ICU admission, and reoperation. Higher ASA score was a significant risk factor for mortality. Conclusion ICU admission after bariatric surgery is uncommon but is associated with a significantly increased mortality. Anastomotic leak, conversions, time from operation to ICU admission, and reoperation have the greatest impact in determining the LOS in the ICU after bariatric surgery.

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