Thursday, June 30, 2011

Resist One Day Surgery for Some Bariatric Procedures

According to a recent article in the Houston Chronicle, while Houston has a rising population, "there's a drop in the number of people using [Houston area] hospital beds and the length of time they spend in them." Among the reasons for the decline in hospital bed usage and length of stay are the tightened restrictions insurance companies have imposed on patient admittance and length of stay. Also among the reasons for the decline is improvement in technology used to treat patients. This improvement is evident, worldwide, in bariatric surgery. Indeed, advances in technology have helped to lower the length of stay associated with a number of bariatric surgical procedures.

Laparoscopic techniques are among the technologies that have contributed to this length of stay shortening. Today, some lap band procedures are done on an outpatient basis, with a patient’s hospital stay being one day.

Now, there is a push by some consultants to make gastric bypass surgery a one day event. However, experts insist that gastric bypass surgery requires a length of stay of at least two days.

Dr. John Morton, "director of bariatric surgery and staff at hospitals and clinics at Stanford University in California," insists that too early discharges would have serious consequences.

Reviewing 51,788 gassing bypass outcomes, Dr. Morton concluded "that patients who left the hospital on the day of the surgery were 12 times more likely to have serious complications than those who stayed for two days." And the 30 day mortality rate was higher for the patients who were released on the day of the bariatric surgery.

Of course, a decrease in hospital length of stay is a money saver in many cases. However, if reducing the length of stay causes complications, the shortened period would likely increase rather than decrease the cost of the surgery. So, the best practice, now, is probably to adhere to a minimum two day length of stay for gastric bypass surgery until the risk of serious complications is lowered.

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Comments:

Blogger Unknown said...

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October 5, 2011 at 5:20 AM  

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