Comparative effectiveness of bariatric procedures among adolescents: the PCORnet bariatric study
Comparative effectiveness of bariatric procedures among adolescents: the PCORnet bariatric study
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DOI：
10.1016/j.soard.2018.04.002
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发表时间：
2018-09-01
影响因子：
3.1
通讯作者：
Michalsky, Marc
中科院分区：
文献类型：
--
作者：
Inge, Thomas H.;Coley, R. Yates;Michalsky, Marc
背景资料：减肥手术已被用于治疗严重肥胖的青少年，但大多数研究一直是小，在follow.Objectives有限：我们假设，电子健康记录数据可以用来比较减肥手术在青少年中的有效性。设置：数据来自临床研究网络，使用一个共同的数据模型，以提取每个网站的数据。方法：确定了从2005年到2015年接受初级减肥手术的青少年。采用随机效应线性回归法对接受所有手术的患者在1年、3年和5年时的体重指数（BMI）变化百分比进行估计。结果：该队列的544名青少年主要是女性（79%）和白色（66%），平均（标准差）年龄为17.3（+/- 1.6）岁，平均BMI为49.8（+/- 7.8）kg/m2。手术包括Roux-en-Y胃旁路术（RYGB; n = 177）、袖状胃切除术（SG; n = 306）和腹腔镜可调节胃束带术（n = 61）。对于接受RYGB、SG和腹腔镜可调节胃束带术的患者，1年时BMI的平均变化（95%置信区间）估计为31%（-30%至-33%）、28%（-27%至-29%）和10%（-8%至-12%）。对于RYGB和SG，BMI的变化为29%（-26%至-33%）和25%（-22%至-28%），估计在3 years.Conclusions：青少年接受SG和RYGB经历了更大的下降，BMI在1年和3年的随访时间点，而腹腔镜可调节胃束带是显着降低BMI的有效性。(Surg Obes Relat Dis 2018;14：13741388.）(C)2018年美国肥胖外科学会。爱思唯尔公司出版这是CC BY-NC-ND许可下的开放获取文章。
Background: Bariatric surgery has been used for treatment of severe obesity in adolescents but most studies have been small and limited in follow-up.Objectives: We hypothesized that electronic health record data could be used to compare effectiveness of bariatric procedures in adolescents.Setting: Data were obtained from clinical research networks using a common data model to extract data from each site.Methods: Adolescents who underwent a primary bariatric procedure from 2005 through 2015 were identified. The percent change in body mass index (BMI) at 1, 3, and 5 years was estimated using random effects linear regression for patients undergoing all operations. Propensity score adjusted estimates and 95% confidence intervals were estimated for procedures with >25 patients at each time period.Results: This cohort of 544 adolescents was predominantly female (79%) and White (66%), with mean (standard deviation) age of 17.3 (+/- 1.6) years and mean BMI of 49.8 (+/- 7.8) kg/m(2). Procedures included Roux-en-Y gastric bypass (RYGB; n = 177), sleeve gastrectomy (SG; n = 306), and laparoscopic adjustable gastric banding (n = 61). For those undergoing RYGB, SG, and laparoscopic adjustable gastric banding, mean (95% confidence interval) BMI changes of 31% (-30% to -33%), 28% (-27% to -29%), and 10% (-8% to -12%), were estimated at 1 year. For RYGB and SG, BMI changes of 29% (-26% to -33%) and 25% (-22% to -28%) were estimated at 3 years.Conclusions: Adolescents undergoing SG and RYGB experienced greater declines in BMI at 1-and 3-year follow-up time points, while laparoscopic adjustable gastric banding was significantly less effective for BMI reduction. (Surg Obes Relat Dis 2018;14:13741388.) (C) 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license.