The aim of the study is investigate the feasibility of same day discharge supported by live video consultation and remote monitoring in a selected group of bariatric patients.
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
(morbide) obesitas patienten
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary outcome is the number of patient (maximum 50 patients) who are
discharged successfully on the same day of the total included patients in 6
months time.
Secondary outcome
Other outcomes will be complications, ER presentations, readmissions, patient
satisfaction and mortality rates.
Background summary
In the Netherlands, over 10.000 bariatric surgeries are performed per year .
This number is expected to rise due to the increase of patients with morbid
obesity These procedures have proven to be safe with morbidity rates of around
3 percent and mortality rates lower than 1 percent.
Several studies have shown that reducing the hospital admission time after
surgery does not affect patient*s short-term safety. Optimisation of hospital
care and shortening of admission time by implementing ERAS (Enhanced Recovery
After Surgery) has resulted in a mean hospital stay of two days (one night in
the hospital).
The risk of developing surgery related complications is independent of the
length of hospital stay but further decreasing the length of stay can delay the
detection of these complications. Therefore, it is important to asses if
further decrease of the admission time is feasible without affecting the
patient outcome or the quality of health care.
Study objective
The aim of the study is investigate the feasibility of same day discharge
supported by live video consultation and remote monitoring in a selected group
of bariatric patients.
Study design
A feasibility study of 50 cases.
Intervention
Eligible patients that meet the criteria of this study will be discharged at
the same day of the operation and will receive video consultation and remote
monitoring during the following day(s).
Same-day discharge is defined as discharge on the day of the surgical procedure
without any overnight hospital stay.
Study burden and risks
By participation in the present study patients will be discharged in the
evening on the same day the surgical procedure took place if the clinical
conditions permit. The next morning, patients will be monitored by live video
consultation combined with remote monitoring of their vital parameters using
their mobile phones. Additional next day video consultation and remote
monitoring is performed if patients still have complaints. All bariatric
patients have a risk of developing signs of a complication regardless of the
length of hospital stay. Late recognition of complications may lead to
increased morbidity and mortality. Chances of complications are limited if
patient feel well and have normal vital parameters. Through video consulting
and remote monitoring we give the same care, but do it remotely. This results
in increase capacity in for the hospital and increased comfort for the patient
recovering in there own environment.
Jan tooropstraat 164
Amsterdam 1061 AE
NL
Jan tooropstraat 164
Amsterdam 1061 AE
NL
Listed location countries
Age
Inclusion criteria
In order to be eligible to participate in this study, a subject must meet all of the following criteria:
- Morbidly obese patients (IFSO criteria of morbid obesity) aged between the 18 and 65 years without significant cardiovascular and/or pulmonary diseases, no previous history of abdominal surgery (excluding appendectomy and ceasarean section)
- Laparoscopic gastric bypass (LRYGB)
- Patient masters the spoken Dutch language
- The surgical procedure is the first or second procedure on the bariatric program of the day
- Patient is able to understand and use the wearable and application
- Residing within a radius of 45 minutes from the OLVG hospital
- A informal carer needs to be at home in the days following surgery.
Exclusion criteria
- Patients diagnosed with uncontrolled diabetes mellitus or use of insulin, obstructive sleep apnea (OSA) with an Apneu Hypopneu Index (AHI) above 15 or use of a CPAP, cardiac disease (history of myocardial infarction, heart rhythm disorder) and coagulation abnormalities or anti-coagulant use.
- Patients with a large abdominal surgeries in the past including abdominal laparotomy.
- Patients undergoing a revisional bariatric surgery, gastric sleeve, other bariatric procedures. ;Secondary exclusion criteria
- There were abnormalities or complications during the surgical procedure
- Vital signs are divergent (tachycardia >100 , temperature above 38 Celsius, hypotension) at the end of the afternoon
- The surgeon, resident or junior resident needs to observe the patient another day because of vomiting, pain, wound problems, doubt.
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
In other registers
| Register | ID |
|---|---|
| CCMO | NL68730.100.19 |
| OMON | NL-OMON27530 |