Department of Gastroenterology, Hospital das Clinicas, ICHC, São Paulo, São Paulo, Brazil.
Obes Surg. 2011 Sep;21(9):1355-61. doi: 10.1007/s11695-011-0404-3.
Consumption of healthcare has been shown to diminish after bariatric treatment, but utilization of hospital services has not been well documented. Aiming to assess this question, a retrospective study with females was designed.
Yearly outpatient appointments, hospital admissions, emergency department visits, and total biochemical tests during 4 years were registered and compared with the preoperative year. Population (N = 176, all females) comprised 94 bariatric candidates submitted to Roux-en-Y gastric bypass (RYGB; age 41.4 ± 10.1 years, BMI 52.2 ± 10.6 kg/m(2)), 34 nonoperated obese controls (age 49.4 ± 8.3 years, BMI 33.8 ± 5.5 kg/m(2)), and 48 colorectal surgical controls (age 44.8 ± 8.6 years, BMI 23.8 ± 4.7 kg/m(2)). Nonbariatric obese patients were fairly well-matched, moderate differences involving higher age and comorbidities. Surgical controls were similarly aged but suffered from less comorbidities.
Obese nonsurgical participants displayed the highest demand for outpatient visits (10.5 ± 0.9/year, P < 0.001) followed by bariatric and colorectal cases (5.7 ± 0.2 and 3.5 ± 0.8, respectively, P = 0.042). Also biochemical measurements were most often required by clinical controls (61.5 ± 5.1/year, P < 0.001), whereas no difference was detected between bariatric and colorectal patients (28.9 ± 2.2 and 33.8 ± 7.7/year, respectively). Elective and emergency admissions were similar for all groups, and part of the postbariatric assistance was related to plastic surgery.
RYGB patients needed 45.8% less outpatient visits and 53.0% less laboratory tests than nonoperated moderately obese cases, even including esthetic operations. Results were comparable to those observed after elective colorectal surgery and remained fairly stable during 4 years.
减重治疗后医疗保健消费已被证实减少，但医院服务的利用情况尚未得到很好的记录。本研究旨在评估这一问题，设计了一项针对女性的回顾性研究。
4 年内每年的门诊预约、住院、急诊就诊和总生化检查均被记录，并与术前一年进行比较。研究人群（N=176，均为女性）包括 94 名接受 Roux-en-Y 胃旁路术（RYGB；年龄 41.4±10.1 岁，BMI 52.2±10.6kg/m²）的减重候选者、34 名未手术肥胖对照者（年龄 49.4±8.3 岁，BMI 33.8±5.5kg/m²）和 48 名结肠直肠手术对照者（年龄 44.8±8.6 岁，BMI 23.8±4.7kg/m²）。非肥胖对照组患者匹配良好，仅年龄和合并症方面存在中等差异。手术对照组年龄相似，但合并症较少。
肥胖非手术组的门诊就诊需求最高（10.5±0.9/年，P<0.001），其次是减重和结肠直肠病例（5.7±0.2 和 3.5±0.8，P=0.042）。同样，临床对照组最常需要进行生化检测（61.5±5.1/年，P<0.001），而减重和结肠直肠患者之间无差异（28.9±2.2 和 33.8±7.7/年，分别）。所有组的择期和急诊入院相似，部分减重后辅助治疗与整形手术有关。
RYGB 患者的门诊就诊次数比未手术的中度肥胖患者减少 45.8%，实验室检查次数减少 53.0%，即使包括美容手术。结果与择期结肠直肠手术后观察到的结果相似，并且在 4 年内相对稳定。
