Mehrotra Chetna, Serdula Mary, Naimi Timothy S, Khan Laura Kettel, Miller Jacqueline, Dietz William
Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Obes Res. 2005 Nov;13(11):2029-34. doi: 10.1038/oby.2005.249.
To describe the trends, costs, and complications associated with weight loss surgery (WLS).
Wisconsin inpatient hospital discharge data from 1990 to 2003 were used for analysis. A WLS case was defined as anyone with a WLS-related procedure code and a primary diagnosis of morbid obesity. Charges were inflation-adjusted to 2001 constant dollars; complications were defined on the basis of readmission, extended length of stay, repeat surgical procedures, or death.
The number of WLSs increased from 269 in 1990 to 1992 to 1,884 in 2000 to 2002 (rate ratio = 4.6). Increases in WLSs were greatest among those 50 to 59 years of age (rate ratio = 6.4), women (rate ratio = 6.8), and blacks (rate ratio = 20.0). Between the two periods, inflation-adjusted WLS charges increased 12-fold, and the inflation-adjusted charge per procedure doubled, despite a decreased length of stay. For 2000 to 2002, 23.3% of WLS patients had either an extended length of stay or readmission within 30 days, 7.4% required a repeat surgical procedure, and 0.7% died.
In Wisconsin, the rate and costs of WLSs have increased dramatically, and the incidence of postoperative complications was high. The epidemic of obesity in the United States makes it imperative to better assess the cost-effectiveness of WLS and to improve its safety.
描述减肥手术（WLS）的趋势、成本及相关并发症。
使用1990年至2003年威斯康星州住院患者出院数据进行分析。减肥手术病例定义为任何具有与减肥手术相关的程序代码且主要诊断为病态肥胖的患者。费用经通货膨胀调整为2001年不变美元；并发症根据再入院、住院时间延长、重复手术或死亡来定义。
减肥手术数量从1990年至1992年的269例增加到2000年至2002年的1884例（率比=4.6）。减肥手术增加幅度最大的是50至59岁人群（率比=6.4）、女性（率比=6.8）和黑人（率比=20.0）。在这两个时期之间，经通货膨胀调整的减肥手术费用增加了12倍，尽管住院时间缩短，但每项手术的经通货膨胀调整费用仍增加了一倍。2000年至2002年，23.3%的减肥手术患者住院时间延长或在30天内再次入院，7.4%的患者需要重复手术，0.7%的患者死亡。
在威斯康星州，减肥手术的发生率和成本大幅增加，术后并发症发生率很高。美国的肥胖流行使得必须更好地评估减肥手术的成本效益并提高其安全性。
