Citation

Lagerros YT, Brandt L, Sundbom M, Hedberg J, Bodén R. Obes. Surg. 2020; 30(7): 2511-2518.

Copyright

(Copyright © 2020, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s11695-020-04483-7

PMID

32152840

PMCID

PMC7260256

Abstract

BACKGROUND: Gastric bypass (GBP) surgery is considered a safe and effective treatment for obesity. However, there is uncertainty regarding the impact of preexisting psychiatric comorbidity on GBP complications. We have investigated whether a psychiatric diagnosis before GBP surgery is associated with delayed discharge (the odds of being in the 90th percentile of length of stay) and rate of reoperation in a nationwide Swedish cohort.
METHODS: Patients undergoing GBP surgery during 2008-2012 were identified and followed up through the National Patient Register and the Prescribed Drug Register. Logistic regression models were fitted to the studied outcomes.
RESULTS: Among the 22,539 patients identified, a prior diagnosis of bipolar disorder, schizophrenia, depression, neurotic disorders, ADHD (attention deficit hyperactivity disorder), substance use disorder, eating disorder, personality disorder, or self-harm since 1997 (n = 9480) was found to be associated with delayed discharge after GBP surgery (odds ratio [OR] = 1.47, confidence interval [CI] 1.34-1.62), especially in patients with psychiatric hospitalization exceeding 1 week in the 2 years preceding GBP surgery (OR = 2.06, CI 1.30-3.28), compared with those not hospitalized within psychiatry. Likewise, patients with a prior psychiatric diagnosis were more likely to be reoperated within 30 days (OR = 1.25, CI 1.11-1.41), with twice the likelihood OR 2.23 (CI 1.26-3.92) for patients with psychiatric hospitalization of up to a week in the 2 years preceding GBP surgery, compared with patients who had not been hospitalized within psychiatry.
CONCLUSIONS: A psychiatric diagnosis before GBP surgery was associated with delayed discharge and increased likelihood of reoperation within 30 days. Patients with a prior psychiatric diagnosis may, therefore, need additional attention and support.

Language: en

Keywords

Humans; Sweden; Comorbidity; Cohort Studies; Mental health; Patient Discharge; Obesity; Bariatric surgery; Reoperation; Length of stay; Postoperative complications; Gastric Bypass; Obesity, Morbid; Patient readmission