Weller Wendy E, Rosati Carl, Hannan Edward L
Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York, University at Albany, NY, USA.
Obes Surg. 2006 Jun;16(6):702-8. doi: 10.1381/096089206777346790.
Our aim was to determine the relationship between patient level characteristics and in-hospital postoperative complications among obese adults who underwent a bariatric procedure in New York state in 2003. Understanding patient level factors that predict or are associated with adverse outcomes among bariatric surgery patients can help to identify patients who need to be monitored particularly carefully.
Using New York's inpatient discharge database, we identified adults who underwent a bariatric operation between January 1, 2003 and December 31, 2003 (n=7,868). Following preliminary descriptive analyses, a stepwise logistic regression model was constructed to identify significant patient level predictors of postoperative complications. Patient level risk factors included age, gender, race/ethnicity, and 24 co-morbid conditions.
6.8% of adults undergoing a bariatric procedure in New York in 2003 experienced one or more of the postoperative complications included in the study. Respiratory complications were the most common type of complication, with >2% of patients experiencing pneumonia, collapsed lung, and/or respiratory complications secondary to the operation. Multivariate analyses by stepwise logistic regression identified age > or =50 years, male gender, Hispanic ethnicity, congestive heart failure, cardiac arrhythmia, other neurological disorders, and peptic ulcer as predictors of complications.
Certain subpopulations of persons undergoing bariatric procedures may be at increased risk for adverse events and will need to be monitored carefully.
我们的目的是确定2003年在纽约州接受减肥手术的肥胖成年人的患者个体特征与术后住院并发症之间的关系。了解减肥手术患者中预测不良结局或与之相关的患者个体因素有助于识别需要特别密切监测的患者。
利用纽约州的住院出院数据库，我们确定了2003年1月1日至2003年12月31日期间接受减肥手术的成年人（n = 7868）。在进行初步描述性分析之后，构建了一个逐步逻辑回归模型，以识别术后并发症的重要患者个体预测因素。患者个体风险因素包括年龄、性别、种族/民族以及24种共病情况。
2003年在纽约接受减肥手术的成年人中有６.８％经历了研究中包含的一种或多种术后并发症。呼吸系统并发症是最常见的并发症类型，超过2％的患者发生了肺炎、肺萎陷和/或手术继发的呼吸系统并发症。通过逐步逻辑回归进行的多变量分析确定年龄≥50岁、男性、西班牙裔、充血性心力衰竭、心律失常、其他神经系统疾病和消化性溃疡为并发症的预测因素。
接受减肥手术的某些亚人群发生不良事件的风险可能增加，需要仔细监测。
