Same-day Discharge Metabolic and Bariatric Surgery: a GRADE-based International Federation for the Surgery and Other Therapies for Obesity (IFSO) Position Statement
摘要
Metabolic and Bariatric Surgery (MBS) is an established treatment for obesity and its associated metabolic conditions. As obesity prevalence has risen globally over the past two decades, so too has MBS utilization, spurring interest in same-day discharge (SDD) protocols as a cost-effective alternative to inpatient hospitalization.
Following the GRADE methodology, this position statement presents a systematic review of all evidence relevant to same-day discharge in MBS.
The current position statement was developed using data from a systematic review and meta-analysis (conducted after Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)) included 17 studies encompassing 46,578 patients; four were randomized controlled trials (RCTs) analyzed in the primary meta-analysis.
The pooled analysis of four RCTs (n = 2,026) revealed no statistically significant differences between SDD and conventional inpatient groups for complication rates (OR: 1.49; 95% CI: 0.63–3.52; p = 0.37), readmissions (OR: 2.20; 95% CI: 0.49–9.87; p = 0.30), or 30-day mortality (OR: 0.87; 95% CI: 0.12–6.22; p = 0.89). This position statement, developed by the IFSO SDD Position Statement Group and approved by the IFSO Scientific Committee, aims to provide a clear, evidence-based overview of the safety and efficacy of SDD protocols in MBS.