Alfa Wali Maryam, Ashrafian Hutan, Schofield Kerry L, Harling Leanne, Alkandari Abdullah, Darzi Ara, Athanasiou Thanos, Efthimiou Evangelos
The Department of Bariatric and Metabolic Surgery, Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK.
Obes Surg. 2014 Dec;24(12):2126-32. doi: 10.1007/s11695-014-1290-2.
Social deprivation is associated with a greater morbidity and shorter life expectancy. This study evaluates differences in weight loss following bariatric surgery and deprivation, based on UK deprivation measures in a London bariatric centre.
All patients undergoing bariatric surgery between 2002 and 2012 were retrospectively identified. Demographic details, type of surgery and percentage excess weight loss data were collected. UK Index of Multiple Deprivation (IMD, 2010) and IMD domain of the Health Deprivation and Disability (HDD) scores were used to assess deprivation (where 1 is the most deprived in rank order and 32,482 is the least deprived). Two-way between-subjects analysis of variance (ANOVA) was performed to examine the effect of IMD score, deprivation, procedure type and gender on percentage excess weight loss.
Data were included from 983 patients (178 male, 805 female) involving 3,663 patient episodes. Treatments comprised laparoscopic gastric bands (n=533), gastric bypass (n=362) and gastric balloons (n=88). The average percentage excess weight loss across all procedures was 38 % over a follow-up period (3 months-9 years). There was no correlation between weight loss and IMD/HDD rank scores. Gastric bypass was significantly more effective at achieving weight loss than the other two procedures at 3-, 6- and 9-month and 1-year follow-up.
Social deprivation does not influence weight loss after bariatric surgery, suggesting that all socioeconomic groups may equally benefit from surgical intervention. Social deprivation should not therefore negatively influence the decision for surgical intervention in these patients.
社会剥夺与更高的发病率和更短的预期寿命相关。本研究基于伦敦一家减肥中心的英国剥夺测量方法,评估减肥手术后体重减轻与剥夺之间的差异。
回顾性确定2002年至2012年间所有接受减肥手术的患者。收集人口统计学细节、手术类型和超重减轻百分比数据。使用英国多重剥夺指数(IMD,2010)以及健康剥夺与残疾(HDD)分数的IMD领域来评估剥夺情况(其中1表示最贫困,按排名顺序,32482表示最不贫困)。进行双因素组间方差分析(ANOVA),以检验IMD分数、剥夺、手术类型和性别对超重减轻百分比的影响。
纳入了983例患者(178例男性,805例女性)的数据,涉及3663次患者病程。治疗方法包括腹腔镜胃束带术(n = 533)、胃旁路手术(n = 362)和胃球囊术(n = 88)。在随访期(3个月至9年)内,所有手术的平均超重减轻百分比为38%。体重减轻与IMD/HDD排名分数之间无相关性。在3个月、6个月、9个月和1年的随访中,胃旁路手术在实现体重减轻方面明显比其他两种手术更有效。
社会剥夺不影响减肥手术后的体重减轻,这表明所有社会经济群体可能同样从手术干预中受益。因此,社会剥夺不应消极影响这些患者进行手术干预的决策。