Increased Admission for Alcohol Dependence After Gastric Bypass Surgery Compared With Restrictive Bariatric Surgery
Increased Admission for Alcohol Dependence After Gastric Bypass Surgery Compared With Restrictive Bariatric Surgery
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DOI：
10.1001/jamasurg.2013.700
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发表时间：
2013-04-01
期刊：
影响因子：
16.9
通讯作者：
Naeslund, Erik
中科院分区：
文献类型：
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作者：
Ostlund, Magdalena Plecka;Backman, Olof;Naeslund, Erik
重要性：我们证明，接受胃旁路手术（GBS）的患者比接受限制性手术的患者因酒精依赖而住院治疗的风险更高。这突出了卫生保健提供者需要意识到这一点，以便早期发现和治疗可以到位。目的：评估GBS前后酒精滥用的住院护理与限制性手术的比较（垂直带状胃成形术和胃束带术）。设计：回顾性基于人群的队列研究，包括所有接受GBS、垂直带状胃成形术，和胃束带手术的研究研究对象：瑞典所有进行减肥手术的医院，研究对象：11115名年龄大于18岁的患者（平均[SD]年龄，40.0 [10.3]岁; 77%的女性），在研究期间接受了初次胃旁路手术、垂直带状胃成形术和胃束带术。酗酒、药物滥用、抑郁症和自杀未遂的住院护理。结果：平均随访时间为8.6年。手术前，接受胃旁路术或限制性手术的患者在酒精滥用的住院治疗方面没有差异（发生率比，1.1; 95%CI，0.8-1.4）。手术后，GBS患者因酒精滥用住院治疗的风险是限制性手术患者的2倍（风险比，2.3; 95% CI，1.7-3.2）结论和相关性：与接受限制性手术的患者相比，接受过GBS的患者术后因酗酒而住院治疗的风险增加了一倍以上，强调了医疗保健专业人员需要意识到这一点，以便早期发现和治疗。
Importance: We demonstrate that patients who have undergone gastric bypass surgery (GBS) have a higher risk of inpatient care for alcohol dependence than those who have undergone restrictive surgery. This highlights a need for health care providers to be aware of this so that early detection and treatment can be put in place.Objective: To evaluate inpatient care for alcohol abuse before and after GBS compared with restrictive surgery (vertical banded gastroplasty and gastric banding).Design: Retrospective population-based cohort study including all patients who underwent GBS, vertical banded gastroplasty, and gastric banding in Sweden from 1980 through 2006. The relative risk of inpatient care for alcohol abuse was studied before and after surgery.Setting: All hospitals in Sweden performing bariatric surgery.Participants: A total of 11 115 patients older than 18 years (mean [SD] age, 40.0 [10.3] years; 77% women) who underwent a primary gastric bypass procedure, vertical banded gastroplasty, and gastric banding during the study period.Main Outcome Measures: Inpatient care for alcohol abuse, substance abuse, depression, and attempted suicide.Results: Mean follow-up time was 8.6 years. Before surgery, there was no difference in inpatient treatment of alcohol abuse among patients who underwent gastric bypass or a restrictive procedure (incidence rate ratio, 1.1; 95% CI, 0.8-1.4). After surgery, there was a 2-fold increased risk of inpatient care for alcohol abuse among patients who had GBS compared with those who had restrictive surgery (hazard ratio, 2.3; 95% CI, 1.7-3.2).Conclusions and Relevance: Patients who had undergone GBS had more than double the risk of inpatient care for alcohol abuse postoperatively compared with patients undergoing a restrictive procedure, highlighting a need for healthcare professionals to be aware of this for early detection and treatment.