Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients
Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients
复制标题
DOI：
10.1097/01.sla.0000137343.63376.19
复制
发表时间：
2004-09-01
影响因子：
9
通讯作者：
MacLean, LD
中科院分区：
文献类型：
--
作者：
Christou, NV;Sampalis, JS;MacLean, LD
目的：本研究验证了减肥手术可降低病态肥胖患者长期死亡率的假设。背景：肥胖是发病率和死亡率的重要原因。手术诱导的长期减肥对死亡率的影响尚不清楚。方法：我们采用观察性2队列研究。治疗队列(n=1035)包括1986至2002年间在麦吉尔大学健康中心接受减肥手术的患者。对照组(n=5746)包括年龄和性别匹配的严重肥胖患者，他们没有接受过魁北克省医疗保险数据库中确定的减重手术。队列开始时有健康状况(除病态肥胖以外)的受试者被排除在外。结果：这些队列在年龄、性别和随访持续时间上都是匹配的。减肥手术导致平均超重减重百分比显著降低(67.1%，P<；0.001)。与对照组相比，减肥手术患者发生心血管疾病、癌症、内分泌疾病、感染性疾病、精神疾病和精神疾病的风险显著降低，但血液系统疾病(无差异)和消化系统疾病(在肥胖队列中发病率增加)除外。减肥手术组的死亡率为0.68%，而对照组为6.17%(相对危险度0.11，95%可信区间0.04-0.27)，这意味着死亡的相对风险降低了89%。结论：本研究表明，减肥手术显著降低了病态肥胖患者的总体死亡率和新的健康相关疾病的发生。
Objective: This study tested the hypothesis that weight-reduction (bariatric) surgery reduces long-term mortality in morbidly obese patients.Background: Obesity is a significant cause of morbidity and mortality. The impact of surgically induced, long-term weight loss on this mortality is unknown.Methods: We used an observational 2-cohort study. The treatment cohort (n = 1035) included patients having undergone bariatric surgery at the McGill University Health Centre between 1986 and 2002. The control group (n = 5746) included age- and gender-matched severely obese patients who had not undergone weightreduction surgery identified from the Quebec provincial health insurance database. Subjects with medical conditions (other then morbid obesity) at cohort-inception into the study were excluded. The cohorts were followed for a maximum of 5 years from inception.Results: The cohorts were well matched for age, gender, and duration of follow-up. Bariatric surgery resulted in significant reduction in mean percent excess weight loss (67.1%, P < 0.001). Bariatric surgery patients had significant risk reductions for developing cardiovascular, cancer, endocrine, infectious, psychiatric, and mental disorders compared with controls, with the exception of hematologic (no difference) and digestive diseases (increased rates in the bariatric cohort). The mortality rate in the bariatric surgery cohort was 0.68% compared with 6.17% in controls (relative risk 0.11, 95% confidence interval 0.04-0.27), which translates to a reduction in the relative risk of death by 89%.Conclusions: This study shows that weight-loss surgery significantly decreases overall mortality as well as the development of new health-related conditions in morbidly obese patients.