Kolotkin Ronette L, Crosby Ross D, Gress Richard E, Hunt Steven C, Adams Ted D
Obesity and Quality of Life Consulting, Durham, North Carolina, USA.
Surg Obes Relat Dis. 2009 Mar-Apr;5(2):250-6. doi: 10.1016/j.soard.2009.01.009. Epub 2009 Jan 31.
Few weight loss surgery trials have evaluated the changes in health-related quality of life (HRQOL) relative to obese individuals not participating in weight loss interventions. In a prospective study at a bariatric surgery practice, we evaluated the 2-year changes in HRQOL in gastric bypass patients compared with 2 severely obese groups who did not undergo surgical weight loss.
A total of 308 gastric bypass patients were compared with 253 individuals who sought but did not undergo gastric bypass and 272 population-based obese individuals using the weight-related (Impact of Weight on Quality of Life-Lite) and general (Medical Outcomes Study 36-item Short-Form Health Survey) HRQOL questionnaires at baseline and 2 years of follow-up.
The percentage of weight loss was 34.2% for the gastric bypass and 1.4% for the no gastric bypass groups, with a .5% gain for population-based obese group. Both measures of HRQOL showed greater improvements for the gastric bypass group, even after controlling for baseline differences. Effect sizes for changes in physical and weight-related HRQOL were very large for gastric bypass, but small to medium for the 2 comparison groups. Effect sizes for changes in the psychosocial aspects of HRQOL were moderate to very large for gastric bypass, but small for the 2 comparison groups. Of the gastric bypass patients, 97% had meaningful improvements in the Impact of Weight on Quality of Life-Lite total score compared with 43% of the no gastric bypass group and 30% of the population-based obese group.
Dramatic improvements had occurred in weight-related and physical HRQOL for gastric bypass patients at 2 years after surgery compared with 2 severely obese groups who had not undergone surgery. These results support the effectiveness of gastric bypass surgery in improving patients' HRQOL.
很少有减肥手术试验评估相对于未参与减肥干预的肥胖个体,健康相关生活质量(HRQOL)的变化。在一家减肥手术诊所进行的一项前瞻性研究中,我们评估了胃旁路手术患者HRQOL的两年变化,并与两组未接受手术减肥的严重肥胖组进行比较。
共有308例胃旁路手术患者与253例寻求胃旁路手术但未进行手术的个体以及272例基于人群的肥胖个体进行比较,在基线和随访2年时使用与体重相关的(生活质量量表简易版)和一般的(医学结局研究36项简短健康调查问卷)HRQOL问卷。
胃旁路手术组体重减轻百分比为34.2%,未进行胃旁路手术组为1.4%,基于人群的肥胖组体重增加0.5%。即使在控制基线差异后,两种HRQOL测量方法均显示胃旁路手术组有更大改善。胃旁路手术在身体和与体重相关的HRQOL变化方面的效应量非常大,但两个比较组的效应量为小到中等。胃旁路手术在HRQOL心理社会方面变化的效应量为中等至非常大,但两个比较组的效应量较小。在胃旁路手术患者中,97%的患者在生活质量量表简易版总分上有有意义的改善,相比之下,未进行胃旁路手术组为43%,基于人群的肥胖组为30%。
与两组未接受手术的严重肥胖组相比,胃旁路手术患者在术后2年时与体重相关的和身体方面的HRQOL有显著改善。这些结果支持胃旁路手术在改善患者HRQOL方面的有效性。