Department of Surgery, Division of General Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
Department of Surgery, Division of General Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
Surg Obes Relat Dis. 2017 Aug;13(8):1290-1295. doi: 10.1016/j.soard.2017.03.027. Epub 2017 Apr 6.
Surgical options have emerged as effective treatments to mitigate obesity-associated co-morbidities leading to reduced mortality risk. Despite the benefits of bariatric surgery, a low portion of the eligible population undergoes weight loss procedures.
To determine if regional disparities exist among bariatric patients in the United States and potential effects of any difference SETTING: National Inpatient Sample (NIS).
We performed a retrospective, cross-sectional analysis of the NIS database from 2003-2010. We identified 4 regions of the United States; Northeast, Midwest, West, and South. Endpoints included race, payor status, co-morbidities, urban/rural areas, institutional academic status, surgeon, and institutional volume. The sample was analyzed using χ tests, linear regression, and multivariate logistical regression analysis.
A total of 132,342 cases and 636,320 controls were studied. A majority of the study population was female (62.5%) and white (70.0%) with private insurance (42.0%). The highest prevalence of obesity was identified in the South (39.7%) and the lowest in the Midwest (17.1%). The greatest numbers of bariatric procedures are performed in the Northeast (24.4%) compared with the South (13.9%) and Midwest (13%). After controlling for demographic characteristics, the proportion of procedures performed in the Northeast compared with the South (odds ratio .52, confidence interval .40-.66; P<.001) and Midwest (odds ratio .50, confidence interval .33-.75; P<.005) was significant.
Significant disparities in bariatric procedures performed were identified in the South and Midwest regions compared with the Northeast. Although the South has a higher prevalence of obesity, thus it could be suggested by outreach programs.
外科手术已经成为减轻肥胖相关合并症并降低死亡率的有效治疗方法。尽管减重手术有好处，但只有一小部分符合条件的人群接受了减肥手术。
确定美国的肥胖症患者是否存在地区差异，以及任何差异的潜在影响。
国家住院患者样本（NIS）。
我们对 2003 年至 2010 年 NIS 数据库进行了回顾性、横断面分析。我们确定了美国的 4 个地区：东北部、中西部、西部和南部。终点包括种族、支付者身份、合并症、城乡地区、机构学术地位、外科医生和机构数量。使用 χ 检验、线性回归和多变量逻辑回归分析对样本进行分析。
共研究了 132342 例病例和 636320 例对照。研究人群中大多数为女性（62.5%）和白人（70.0%），有私人保险（42.0%）。南部肥胖的发病率最高（39.7%），中西部最低（17.1%）。东北部（24.4%）进行的减重手术数量最多，而南部（13.9%）和中西部（13%）则较少。在控制了人口统计学特征后，与南部（优势比.52，置信区间.40-.66；P<.001）和中西部（优势比.50，置信区间.33-.75；P<.005）相比，东北部进行手术的比例显著更高。
与东北部相比，南部和中西部地区进行的减重手术存在显著差异。尽管南部肥胖症的患病率较高，但可以通过外展计划来加以解决。
