Risk factors for XXXX in laparoscopic gastric bypass.

@entity1 @entity286 @entity295 @entity101 @entity6 @entity86 @entity204
INTRODUCTION: @entity86 is a rare but serious complication following elective surgery. The purpose of this study was to identify the rate of @entity86 following elective laparoscopic gastric bypass (LGBP) and to identify @entity1 ' modifiable, preoperative risk factors. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2005 to 2013 for factors associated with the development of @entity86 following elective LGBP. @entity1 who developed @entity295 were compared to those who did not. Results were analyzed using the Chi-square test for categorical variables and Wilcoxon two-sample test for continuous variables. A multivariate logistic regression analysis was utilized to calculate adjusted odds ratios for factors contributing to @entity295 . RESULTS: During the study period, 66,838 @entity1 underwent LGBP. Of those, 546 @entity1 developed @entity86 (0.82  %). The development of @entity295 was associated with increased operative time (161      77.8 vs. 135.10      56.5  min; p  <  0.0001) and a greater number of preoperative comorbidities, including @entity6 (39.6 vs. 30.6  %; p  <  0.0001), @entity101 requiring medication (65.2 vs. 54  %; p  <  0.0001), current @entity286 use (16.7 vs. 11.5  %; p  =  0.0002), and increased pack-year history of smoking (8.6      18.3 vs. 5.6      14.2; p  =  0.0006), and the Charlson Comorbidity Index (0.51      0.74 vs. 0.35      0.57, p  <  0.0001). @entity295 resulted in an increased length of stay (10.1      14.4 vs. 2.4      4.8  days; p  <  0.0001) and a 30 times greater chance of 30-day mortality (4.03 vs. 0.11  %, p  <  0.0001). Multivariate logistic regression analysis showed that current smokers had a 63  % greater chance of developing @entity295 compared to non-smokers, controlling for age, race, gender, BMI, and CCI score (OR 1.63, 95  % CI 1.23-2.14; p  =  0.0006). CONCLUSIONS: Laparoscopic gastric bypass is uncommonly associated with @entity86 . When it occurs, it portends a 30 times increased risk of @entity204 . A @entity1 history of @entity6 , @entity101 , and increasing pack-years of smoking portend an increased risk of @entity295 . Current smoking status, a preoperative modifiable risk factor, is independently associated with the chance of @entity86 . Preoperative @entity1 optimization and risk reduction should be a priority for elective surgery, and @entity1 should be encouraged to stop smoking prior to gastric bypass.
