Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Catholic University of the Sacred Heart, Rome, Italy.
Int J Obes (Lond). 2019 Apr;43(4):933-937. doi: 10.1038/s41366-018-0097-y. Epub 2018 May 24.
Obesity increases risk of falling, but the effect of bariatric surgery on fall-related injuries is unknown. The aim of this study was therefore to study the association between bariatric surgery and long-term incidence of fall-related injuries in the prospective, controlled Swedish Obese Subjects study. At inclusion, body mass index was ≥ 34 kg/m in men and ≥38 kg/m in women. The surgery per-protocol group (n = 2007) underwent gastric bypass (n = 266), banding (n = 376), or vertical banded gastroplasty (n = 1365), and controls (n = 2040) received usual care. At the time of analysis (31 December 2013), median follow-up was 19 years (maximal 26 years). Fall-related injuries requiring hospital treatment were captured using data from the Swedish National Patient Register. During follow-up, there were 617 first-time fall-related injuries in the surgery group and 513 in the control group (adjusted hazard ratio 1.21, 95% CI, 1.07-1.36; P = 0.002). The incidence differed between treatment groups (P < 0.001, log-rank test) and was higher after gastric bypass than after usual care, banding and vertical banded gastroplasty (adjusted hazard ratio 0.50-0.52, P < 0.001 for all three comparisons). In conclusion, gastric bypass surgery was associated with increased risk of serious fall-related injury requiring hospital treatment.
肥胖增加了跌倒的风险，但减重手术对跌倒相关损伤的影响尚不清楚。因此，本研究旨在研究前瞻性、对照的瑞典肥胖受试者研究中减重手术与长期跌倒相关损伤发生率之间的关联。纳入时，男性 BMI≥34kg/m2，女性 BMI≥38kg/m2。手术协议组（n=2007）接受胃旁路手术（n=266）、带手术（n=376）或垂直带胃成形术（n=1365），对照组（n=2040）接受常规护理。在分析时（2013 年 12 月 31 日），中位随访时间为 19 年（最长 26 年）。使用瑞典国家患者登记处的数据捕获需要住院治疗的跌倒相关损伤。随访期间，手术组有 617 例首次跌倒相关损伤，对照组有 513 例（调整后的危险比 1.21，95%CI，1.07-1.36；P=0.002）。治疗组之间的发生率存在差异（P<0.001，对数秩检验），胃旁路手术后高于常规护理、带手术和垂直带胃成形术（调整后的危险比为 0.50-0.52，所有三种比较均 P<0.001）。总之，胃旁路手术与严重跌倒相关损伤导致需要住院治疗的风险增加相关。
