ABSTRACT
BACKGROUND: Crohn's disease (CD) in association with obesity is becoming an increasing issue in Australia and worldwide. This report looks at outcomes for patients with CD undergoing laparoscopic sleeve gastrectomy. METHODS: This is a retrospective analysis of our database of patients undergoing laparoscopic sleeve gastrectomy from 2007 to 2016. Patients with concurrent CD were included. RESULTS: Eight patients with CD underwent laparoscopic sleeve gastrectomy with a mean preoperative body mass index of 43.8. There were no identified intraoperative or post-operative complications. The mean excess weight loss was 55.7% and 56.5% at 6 months and 1 year, respectively. CONCLUSION: Laparoscopic sleeve gastrectomy can be achieved in CD patients. No complications and effective weight loss was observed in the eight reported patients.
Subject(s)
Crohn Disease/epidemiology , Gastrectomy/methods , Obesity, Morbid/epidemiology , Obesity, Morbid/surgery , Patient Safety/statistics & numerical data , Weight Loss/physiology , Adult , Australia , Body Mass Index , Comorbidity , Crohn Disease/diagnosis , Crohn Disease/surgery , Databases, Factual , Female , Follow-Up Studies , Gastrectomy/adverse effects , Humans , Male , Middle Aged , Obesity, Morbid/diagnosis , Retrospective Studies , Risk Assessment , Time Factors , Treatment OutcomeABSTRACT
AIM: To assess how many health professionals are directly involved in a patient's stay at Auckland City Hospital, Auckland, New Zealand. METHODS: A retrospective review of the records was carried out of all patients admitted through the Admission and Planning Unit and the Emergency Department on a chosen day. Every health professional who wrote in the medical notes was counted and tabulated for each patient. RESULTS: 81 patients were admitted--47 medical and 34 surgical. In medicine, the patients saw an average of 17.8 health professionals during their hospitalisation (95%CI 0.0-36.7) (median 17) (range 5 to 44); an average of 6.0 doctors (0.0-12.6) (5) (2-21); 10.7 nurses (0.0-22.3) (11) (3-24); and 1.0 allied health workers (0.0-4.5) (0) (0-6). In surgery, the patients saw an average of 26.6 health professionals during their hospitalisation (95%CI 0.0-66.7) (median 21.5) (range 2 to 75); an average of 10.0 doctors (0.0-25.8) (8.5) (1-33); 15.9 nurses (0.0-39.2) (13.5) (1-44); and 0.8 allied health workers (0-3.3) (0) (0-4). CONCLUSIONS: Modern hospital healthcare delivery involves many different healthcare professionals. Patients have more nurse contacts than doctors (p<0.0001). Surgical patients see more health professionals than medical patients overall (p=0.01) but the daily rate was not found to be statistically different (p=0.3). Involvement of different health professionals may necessitate good communication/handover processes as well as possible changes to traditional training methods.
