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胃旁路术后两年通用型和肥胖特异性生活质量的变化。

Two-year changes in generic and obesity-specific quality of life after gastric bypass.

机构信息

Clinical Management Service, Alto Deba Hospital, Mondragon, Spain,

出版信息

Eat Weight Disord. 2013 Sep;18(3):305-10. doi: 10.1007/s40519-013-0039-6. Epub 2013 May 17.

Abstract

The study objectives were to assess 2-year changes in health-related quality of life (HRQL) after gastric bypass in patients with severe obesity and to analyze HRQL improvements in relation to weight loss after bariatric surgery. This was a prospective intervention study with consecutive patients referred to two bariatric surgical units in the Basque Country. We used both generic (Short Form Health Survey, SF-36 and EuroQol, EQ-5D), and specific questionnaires (Moorehead-Ardelt, MA II and Obesity-related Problems Scale, OP). Effect sizes and receiver operating characteristic (ROC) curves were calculated to assess the change in quality of life. Spearman's correlation coefficient was calculated to assess whether there was an association between changes in body mass index (BMI) and HRQL. Of 82 patients who underwent surgery, 79 were followed-up for 2 years. Mean weight loss was 37% of body weight (49 kg) and BMI fell from 50.6 to 31.8. The initial problems and final improvements were greater in the physical dimensions. Considerable benefits were observed in assessments with all the instruments used. However, the changes in weight/BMI and HRQL were not linear. The comparison with general population showed a similar profile in SF-36 dimensions after surgery. Severely obese patients have lower perceived health across all dimensions of quality of life. Moreover, the impact on functioning is so important that severe obesity can be described as a cause of disability that disappears 2 years after surgical treatment. ROC curves indicate that most of the HRQL measures are poor predictors of change in terms of reduction in body weight or BMI.

摘要

研究目的是评估严重肥胖患者胃旁路手术后 2 年的健康相关生活质量(HRQL)变化,并分析减肥与减重手术后 HRQL 改善的关系。这是一项前瞻性干预研究,纳入了巴斯克地区的两个减肥手术单位的连续患者。我们使用了通用的(健康调查短表,SF-36 和欧洲五维健康量表,EQ-5D)和特定的问卷(Moorehead-Ardelt,MA II 和肥胖相关问题量表,OP)。我们计算了效应大小和接收者操作特征(ROC)曲线来评估生活质量的变化。计算了 Spearman 相关系数来评估 BMI 的变化与 HRQL 之间是否存在关联。在接受手术的 82 名患者中,有 79 名随访了 2 年。平均体重减轻了 37%的体重(49 公斤),体重指数从 50.6 降至 31.8。身体维度的初始问题和最终改善更大。所有使用的仪器评估都观察到了相当大的益处。然而,体重/体重指数和 HRQL 的变化不是线性的。与普通人群的比较显示,手术后 SF-36 维度的情况相似。严重肥胖患者在所有生活质量维度上的健康感知都较低。此外,对功能的影响如此重要,以至于严重肥胖可以被描述为一种残疾,这种残疾在手术后 2 年内消失。ROC 曲线表明,大多数 HRQL 测量在体重或 BMI 减少方面是预测变化的较差指标。

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