Morbidly obese patients--who undergoes bariatric surgery?
Morbidly obese patients--who undergoes bariatric surgery?
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DOI：
10.1007/s11695-009-0053-y
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发表时间：
2010-08
期刊：
影响因子：
2.9
通讯作者：
Hjelmesaeth, Joran
中科院分区：
文献类型：
--
作者：
Jakobsen, Gunn Signe;Hofso, Dag;Roislien, Jo;Sandbu, Rune;Hjelmesaeth, Joran
减肥手术尤其有利于肥胖相关合并症患者，如2型糖尿病和阻塞性睡眠呼吸暂停。我们的目的是研究影响治疗选择的变量在接受减肥手术的病态肥胖患者和选择保守治疗的患者之间是否存在差异。2005年12月至2007年2月期间，505例连续的病态肥胖患者（72%为女性，平均（SD）年龄42（12）岁）在我们的三级保健中心接受了多学科团队的检查，并接受了手术或保守治疗。统计分析采用卡方检验、独立样本t检验和多元逻辑回归。共有249例（49%）患者接受了减肥手术。与保守组患者相比，手术组患者的平均BMI （SD）明显高于保守组(46.5(6.2)vs. 43.2(5.5) kg/m2, p < 0.001)，肥胖发病较早（12岁前40% vs. 26%, p < 0.001），年龄较低(41（11)vs. 44（13）岁，p = 0.002）。相比之下，两组在性别或肥胖相关合并症方面没有显著差异。在调整性别、年龄、肥胖发病和合并症数量后，多元回归显示BMI 40 - 50或>50 kg/m2的患者接受减肥手术的机会是BMI <40 kg/m2的患者的3倍（or = 3.0; 95% CI 1.9-4.9, p < 0.001）和6倍（or = 5.7; 95% CI 3.0 - 11.0, p < 0.001）（参考）。我们的数据表明，BMI的增加而不是肥胖相关的合并症，预测了病态肥胖患者的治疗选择。
Bariatric surgery particularly benefits patients with obesity-related comorbidities such as type 2 diabetes and obstructive sleep apnea. We aimed to examine whether the variables that influence treatment choice differ between morbidly obese patients undergoing bariatric surgery and those opting for conservative treatments. A total of 505 consecutive morbidly obese patients (72% women; mean (SD) age 42 (12) years) who attended our tertiary care center between December 2005 and February 2007 were examined by a multidisciplinary team and offered surgical or conservative treatment. The chi-square test, independent samples t test, and multiple logistic regression were used in the statistical analyses. A total of 249 (49%) patients underwent bariatric surgery. When compared to the conservative group of patients, the surgery group was characterized by a significantly higher mean (SD) BMI (46.5(6.2) vs. 43.2(5.5) kg/m2, p < 0.001), earlier onset of obesity (40% vs. 26% before 12 years of age, p < 0.001), and lower age (41(11) vs. 44(13) years, p = 0.002). In contrast, the groups did not differ significantly with respect to gender or obesity-related comorbidities. After adjustments for gender, age, onset of obesity, and the number of comorbidities, multiple regression revealed that patients with BMI 40–50 or >50 kg/m2 had between 3 (OR = 3.0; 95% CI 1.9–4.9, p < 0.001) and 6 (OR = 5.7; 95% CI 3.0–11.0, p < 0.001) times the chance of undergoing bariatric surgery when compared to patients with a BMI <40 kg/m2 (reference). Our data indicates that increasing BMI rather than obesity-related comorbidities, predicted treatment choice in morbidly obese patients.
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