Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark.
The Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
Ann Surg. 2018 Feb;267(2):319-325. doi: 10.1097/SLA.0000000000002113.
To examine rates of acute inpatient hospital admissions patients undergoing Roux-en-Y gastric bypass (RYGB) surgery and a matched population-based comparison cohort.
Little is known about the admission rates before and after RYGB.
Nationwide population-based cohort study, including all 9985 patients undergoing RYGB in Denmark during 2006 to 2010, and 247,375 matched general population comparisons. We calculated cumulative incidence of surgical complications after RYGB and incidence rate ratios (RRs) of hospital admission in RYGB patients versus comparisons before and after RYGB.
Admissions for surgical complications occurred in 3.3% (n = 328) of RYGB patients <30 days after surgery and in 23.9% (n = 2367) during entire follow-up (median 4.2 yrs). Fifteen percent (n = 1486) were admitted with abdominal pain, 5.2% (n = 518) with intestinal obstruction during follow-up. Overall admission rates in RYGB patients versus comparisons were 11.5 versus 5.9 per 100 person-years before RYGB [RR = 1.95 (95% confidence interval (CI): 1.89-2.01)], increasing to 24.9 versus 7.1 per 100 person-years after RYGB [RR = 3.38 (95% CI; 3.30, 3.47)]. RRs of cardiovascular and chronic pulmonary disease admissions decreased considerably. RRs increased for alcohol abuse [0.59 (95% CI; 0.39-0.88) to 2.17 (95% CI; 1.72-2.72)], self-harm (suicide attempts, medication overuse) [1.72 (95% CI; 1.32-2.25) to 3.61 (95% CI; 2.88-4.52)], anemia [0.84 (95% CI; 0.39-1.78) to 17.92 (95% CI; 14.94-21.48)], and osteoporosis [1.19 (95% CI; 0.93-1.53) to 1.65 (95% CI; 1.35-2.02)].
Short-term surgical complications occurred in 3% and long-term complications in one-fourth of RYGB patients. Compared with the general population, the RR for any inpatient admission increased after RYGB.
调查接受 Roux-en-Y 胃旁路术(RYGB)的患者和匹配的基于人群的对照队列的急性住院入院率。
对于 RYGB 前后的入院率知之甚少。
这是一项全国性的基于人群的队列研究,包括 2006 年至 2010 年期间在丹麦接受 RYGB 的 9985 名患者和 247375 名匹配的普通人群对照。我们计算了 RYGB 后手术并发症的累积发生率和 RYGB 患者与 RYGB 前后对照相比的住院入院率比值(RR)。
30 天内接受 RYGB 的患者中,有 3.3%(n=328)发生手术并发症,整个随访期间(中位数 4.2 年)有 23.9%(n=2367)发生手术并发症。15%(n=1486)因腹痛入院,5.2%(n=518)因肠梗阻入院。与对照组相比,RYGB 患者在 RYGB 前的总入院率为 11.5 例/100 人年,RR=1.95(95%CI:1.89-2.01),在 RYGB 后增加到 24.9 例/100 人年,RR=3.38(95%CI;3.30,3.47)。心血管和慢性肺部疾病入院的 RR 显著降低。酒精滥用(RR=0.59(95%CI;0.39-0.88)至 2.17(95%CI;1.72-2.72))、自残(自杀企图、药物滥用)(RR=1.72(95%CI;1.32-2.25)至 3.61(95%CI;2.88-4.52))、贫血(RR=0.84(95%CI;0.39-1.78)至 17.92(95%CI;14.94-21.48))和骨质疏松症(RR=1.19(95%CI;0.93-1.53)至 1.65(95%CI;1.35-2.02))的 RR 增加。
RYGB 患者短期手术并发症发生率为 3%,长期并发症发生率为四分之一。与普通人群相比,RYGB 后任何住院入院的 RR 增加。