病态肥胖症及减肥手术应用的国家差异。

National variations in morbid obesity and bariatric surgery use.

作者信息

Poulose Benjamin K, Holzman Michael D, Zhu Yuwei, Smalley Walter, Richards William O, Wright J Kelly, Melvin Willie, Griffin Marie R

机构信息

Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.

出版信息

J Am Coll Surg. 2005 Jul;201(1):77-84. doi: 10.1016/j.jamcollsurg.2005.03.022.

DOI:10.1016/j.jamcollsurg.2005.03.022

PMID:15978447

Abstract

BACKGROUND

Exploring bariatric surgery use provides data on effective treatment allocation. This study analyzed national rates of bariatric surgery use and the burden of morbid obesity by gender, census region, and age.

STUDY DESIGN

Patients 18 years of age or older undergoing bariatric surgery were identified from the US 2002 Nationwide Inpatient Sample, and the national morbidly obese population 18 years of age or older was determined using the Centers for Disease Control and Prevention 2002 Behavioral Risk Factor Surveillance System databases. General population data were obtained from 2000 census data. Annual rates of bariatric surgery procedures were determined by gender, age group, and census region (Northeast, Midwest, South, and West). Rate ratios were calculated and significance tested through 95% confidence intervals (95% CI), accounting for the Nationwide Inpatient Sample and Behavioral Risk Factor Surveillance System sampling design.

RESULTS

In 2002, a national cohort of 69,490 bariatric surgery patients was identified. Of these patients 85% were women and 76% were ages 18 to 49 years. The prevalence of morbid obesity (body mass index > or = 40 kg/m(2)) in the US in 2002 was 1.8%; 60% of morbidly obese people were women, and 63% were ages 18 to 49 years. The rates of bariatric surgery procedures per 100,000 morbidly obese individuals ranged from a low of 139 in men aged 60 years and older in the Midwest to a high of 5,156 in women ages 40 to 49 years in the Northeast. For both men and women, bariatric surgery rates in the West and Northeast were 1.35 (95% CI 1.31 to 1.40, p < 0.05) to 4.51 (95% CI 4.15 to 4.89, p < 0.05) times higher than in the South, respectively; rates in the Midwest were similar to those in the South.

CONCLUSIONS

National estimates suggest that bariatric surgery rates do not parallel the burden of morbid obesity by region or age. Additional evaluation of these differences is necessary for optimal bariatric surgery use.

摘要

背景

探究减肥手术的使用情况可提供有效治疗分配的数据。本研究分析了全国减肥手术的使用比率以及按性别、普查区域和年龄划分的病态肥胖负担。

研究设计

从2002年美国全国住院患者样本中确定接受减肥手术的18岁及以上患者，并使用疾病控制与预防中心2002年行为危险因素监测系统数据库确定全国18岁及以上的病态肥胖人群。一般人群数据来自2000年的人口普查数据。减肥手术的年发生率按性别、年龄组和普查区域（东北部、中西部、南部和西部）确定。计算比率比并通过95%置信区间（95%CI）进行显著性检验，同时考虑全国住院患者样本和行为危险因素监测系统的抽样设计。

结果

2002年，确定了一个由69490名减肥手术患者组成的全国队列。这些患者中85%为女性，76%年龄在18至49岁之间。2002年美国病态肥胖（体重指数≥40kg/m²）的患病率为1.8%；60%的病态肥胖者为女性，63%年龄在18至49岁之间。每100000名病态肥胖个体的减肥手术发生率范围从中西部60岁及以上男性的低至139例到东北部40至49岁女性的高至5156例。对于男性和女性，西部和东北部的减肥手术发生率分别比南部高1.35倍（95%CI 1.31至1.40，p<0.05）至4.51倍（95%CI 4.15至4.89，p<0.05）；中西部的发生率与南部相似。