Cargando…
Markers for Major Complications at Day-One Postoperative in Fast-Track Metabolic Surgery: Updated Metabolic Checklist
INTRODUCTION: In fast-track metabolic surgery, the window to identify complications is narrow. Postoperative checklists can be useful tools in the decision-making of safe early discharge. The aim of this study was to evaluate the predictive value of a checklist used in metabolic surgery. METHODS: Re...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514089/ https://www.ncbi.nlm.nih.gov/pubmed/37610699 http://dx.doi.org/10.1007/s11695-023-06782-1 |
_version_ | 1785108652497043456 |
---|---|
author | Hart, J. W. H. ‘t Takken, R. Hogewoning, C. R. C. Biter, L. U. Apers, J. A. Zengerink, H. Dunkelgrün, M. Verhoef, C. |
author_facet | Hart, J. W. H. ‘t Takken, R. Hogewoning, C. R. C. Biter, L. U. Apers, J. A. Zengerink, H. Dunkelgrün, M. Verhoef, C. |
author_sort | Hart, J. W. H. ‘t |
collection | PubMed |
description | INTRODUCTION: In fast-track metabolic surgery, the window to identify complications is narrow. Postoperative checklists can be useful tools in the decision-making of safe early discharge. The aim of this study was to evaluate the predictive value of a checklist used in metabolic surgery. METHODS: Retrospective data from June 2018 to January 2021 was collected on all patients that underwent metabolic surgery in a high-volume bariatric hospital in the Netherlands. Patients without an available checklist were excluded. The primary outcome was major complications and the secondary outcomes were minor complications, readmission, and unplanned hospital visits within 30 days postoperatively. RESULTS: Major complications within 30 days postoperatively occurred in 62/1589 (3.9%) of the total included patients. An advise against early discharge was significantly more seen in patients with major complications compared to those without major complications (90.3% versus 48.1%, P < 0.001, respectively), and a negative checklist (advice for discharge) had a negative predictive value of 99.2%. The area under the curve for the total checklist was 0.80 (P < 0.001). Using a cut-off value of ≥3 positive points, the sensitivity and specificity were 65% and 82%, respectively. Individual parameters from the checklist: oral intake, mobilization, calf pain, willingness for discharge, heart rate, drain (>30 ml/24 h), hemoglobin, and leukocytes count were also significantly different between groups. CONCLUSION: This checklist is a valuable tool to decide whether patients can be safely discharged early. Heart rate appeared to be the most predictive parameter for the development of major complications. Future studies should conduct prediction models to identify patients at risk for major complications. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11695-023-06782-1. |
format | Online Article Text |
id | pubmed-10514089 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-105140892023-09-23 Markers for Major Complications at Day-One Postoperative in Fast-Track Metabolic Surgery: Updated Metabolic Checklist Hart, J. W. H. ‘t Takken, R. Hogewoning, C. R. C. Biter, L. U. Apers, J. A. Zengerink, H. Dunkelgrün, M. Verhoef, C. Obes Surg Original Contributions INTRODUCTION: In fast-track metabolic surgery, the window to identify complications is narrow. Postoperative checklists can be useful tools in the decision-making of safe early discharge. The aim of this study was to evaluate the predictive value of a checklist used in metabolic surgery. METHODS: Retrospective data from June 2018 to January 2021 was collected on all patients that underwent metabolic surgery in a high-volume bariatric hospital in the Netherlands. Patients without an available checklist were excluded. The primary outcome was major complications and the secondary outcomes were minor complications, readmission, and unplanned hospital visits within 30 days postoperatively. RESULTS: Major complications within 30 days postoperatively occurred in 62/1589 (3.9%) of the total included patients. An advise against early discharge was significantly more seen in patients with major complications compared to those without major complications (90.3% versus 48.1%, P < 0.001, respectively), and a negative checklist (advice for discharge) had a negative predictive value of 99.2%. The area under the curve for the total checklist was 0.80 (P < 0.001). Using a cut-off value of ≥3 positive points, the sensitivity and specificity were 65% and 82%, respectively. Individual parameters from the checklist: oral intake, mobilization, calf pain, willingness for discharge, heart rate, drain (>30 ml/24 h), hemoglobin, and leukocytes count were also significantly different between groups. CONCLUSION: This checklist is a valuable tool to decide whether patients can be safely discharged early. Heart rate appeared to be the most predictive parameter for the development of major complications. Future studies should conduct prediction models to identify patients at risk for major complications. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11695-023-06782-1. Springer US 2023-08-23 2023 /pmc/articles/PMC10514089/ /pubmed/37610699 http://dx.doi.org/10.1007/s11695-023-06782-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Contributions Hart, J. W. H. ‘t Takken, R. Hogewoning, C. R. C. Biter, L. U. Apers, J. A. Zengerink, H. Dunkelgrün, M. Verhoef, C. Markers for Major Complications at Day-One Postoperative in Fast-Track Metabolic Surgery: Updated Metabolic Checklist |
title | Markers for Major Complications at Day-One Postoperative in Fast-Track Metabolic Surgery: Updated Metabolic Checklist |
title_full | Markers for Major Complications at Day-One Postoperative in Fast-Track Metabolic Surgery: Updated Metabolic Checklist |
title_fullStr | Markers for Major Complications at Day-One Postoperative in Fast-Track Metabolic Surgery: Updated Metabolic Checklist |
title_full_unstemmed | Markers for Major Complications at Day-One Postoperative in Fast-Track Metabolic Surgery: Updated Metabolic Checklist |
title_short | Markers for Major Complications at Day-One Postoperative in Fast-Track Metabolic Surgery: Updated Metabolic Checklist |
title_sort | markers for major complications at day-one postoperative in fast-track metabolic surgery: updated metabolic checklist |
topic | Original Contributions |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514089/ https://www.ncbi.nlm.nih.gov/pubmed/37610699 http://dx.doi.org/10.1007/s11695-023-06782-1 |
work_keys_str_mv | AT hartjwht markersformajorcomplicationsatdayonepostoperativeinfasttrackmetabolicsurgeryupdatedmetabolicchecklist AT takkenr markersformajorcomplicationsatdayonepostoperativeinfasttrackmetabolicsurgeryupdatedmetabolicchecklist AT hogewoningcrc markersformajorcomplicationsatdayonepostoperativeinfasttrackmetabolicsurgeryupdatedmetabolicchecklist AT biterlu markersformajorcomplicationsatdayonepostoperativeinfasttrackmetabolicsurgeryupdatedmetabolicchecklist AT apersja markersformajorcomplicationsatdayonepostoperativeinfasttrackmetabolicsurgeryupdatedmetabolicchecklist AT zengerinkh markersformajorcomplicationsatdayonepostoperativeinfasttrackmetabolicsurgeryupdatedmetabolicchecklist AT dunkelgrunm markersformajorcomplicationsatdayonepostoperativeinfasttrackmetabolicsurgeryupdatedmetabolicchecklist AT verhoefc markersformajorcomplicationsatdayonepostoperativeinfasttrackmetabolicsurgeryupdatedmetabolicchecklist |