Obesity as a Risk Factor for Unanticipated Admissions After Ambulatory Surgery

Obesity as a Risk Factor for Unanticipated Admissions After Ambulatory Surgery

OBJECTIVE To test the hypothesis that obesity is an independent risk factor for unplanned hospital admission or readmission among patients scheduled for ambulatory surgery in a tertiary medical center. PATIENTS AND METHODS Existing databases were used to identify 235 obese patients (body mass index [BMI] >40) scheduled for ambulatory surgery from January 2, 2002, through December 31, 2003, at Mayo Clinic's site in Rochester, MN. Each patient was matched to a normal-weight control (BMI <25) by age, sex, surgical procedure, type of anesthesia, and date of surgery, and the medical records of all patients were reviewed. Conditional logistic regression analysis was performed to assess whether obesity is an independent risk factor for unplanned postoperative hospital admission. In all cases, 2-sided tests were performed. P<.05 was considered statistically significant. RESULTS Obese patients (mean ± SD BMI, 44±4) were matched with control patients (mean ± SD BMI, 23±2). Comorbidity was more frequent in the obese cohort. The frequency of unplanned hospital admission did not differ between groups: 61 obese patients (26.0%) and 52 control patients (22.1%) were admitted (odds ratio, 1.3; 95% confidence interval, 0.8-2.0; P=.30). CONCLUSION Obesity is not a significant independent risk factor for unplanned admission after ambulatory surgery, suggesting that obesity per se should not prevent ambulatory surgery from being scheduled.

目的 检验在一家三级医疗中心，肥胖是否是计划进行门诊手术的患者非计划住院或再入院的独立危险因素这一假设。 患者与方法 利用现有数据库，确定2002年1月2日至2003年12月31日期间在明尼苏达州罗切斯特市梅奥诊所计划进行门诊手术的235名肥胖患者（体重指数[BMI]>40）。按照年龄、性别、手术程序、麻醉类型和手术日期，为每位患者匹配一名体重正常的对照者（BMI<25），并查阅所有患者的病历。进行条件逻辑回归分析以评估肥胖是否是术后非计划住院的独立危险因素。在所有情况下，均进行双侧检验。P<0.05被视为具有统计学意义。 结果 肥胖患者（平均±标准差BMI为44±4）与对照患者（平均±标准差BMI为23±2）相匹配。肥胖组的合并症更为常见。两组之间非计划住院的频率没有差异：61名肥胖患者（26.0%）和52名对照患者（22.1%）住院（比值比为1.3；95%置信区间为0.8 - 2.0；P = 0.30）。 结论 肥胖不是门诊手术后非计划入院的显著独立危险因素，这表明肥胖本身不应妨碍安排门诊手术。