Alam M, Bhanderi S, Matthews J H, McNulty D, Pagano D, Small P, Singhal R, Welbourn R
Upper Gastrointestinal and Bariatric Unit, Heartlands Hospital, Heart of England NHS Foundation Trust Birmingham UK.
Health Informatics University Hospital Birmingham NHS Foundation Trust Birmingham UK.
BJS Open. 2017 Oct 26;1(4):122-127. doi: 10.1002/bjs5.20. eCollection 2017 Aug.
Bariatric surgery is an accepted treatment option for severe obesity. Previous analysis of the independently collected Hospital Episode Statistics (HES) data for outcomes after bariatric surgery demonstrated a 30-day postoperative mortality rate of 0·3 per cent in the English National Health Service (NHS). However, there have been no published mortality data for bariatric procedures performed since 2008. This study aimed to assess mortality related to bariatric surgery in England from 2009.
HES data were used to identify all patients who had primary bariatric surgery from 2009 to 2016. Clinical codes were used selectively to identify all primary bariatric procedures but exclude revision or conversion procedures and operations for malignant or other benign disease. The primary outcome measures were HES in-hospital and Office for National Statistics (ONS) 30-day mortality after discharge.
A total of 41 241 primary bariatric procedures were carried out in the NHS between 2009 and 2016, with 29 in-hospital deaths (0·07 per cent). The 30-day mortality rate after discharge was 0·08 per cent (32 of 41 241). Both the in-hospital and 30-day mortality rates after discharge demonstrated a downward trend over the study period.
Overall in-hospital and 30-day mortality rates remain very low after primary bariatric surgery. An increased uptake of bariatric surgery within the English NHS has been safe.
减肥手术是治疗重度肥胖的一种公认的治疗选择。此前对独立收集的医院事件统计数据（HES）进行的减肥手术后结局分析显示，在英国国家医疗服务体系（NHS）中，术后30天死亡率为0.3%。然而，自2008年以来，尚无关于减肥手术的已发表死亡率数据。本研究旨在评估2009年以来英国减肥手术相关的死亡率。
使用HES数据确定2009年至2016年期间接受初次减肥手术的所有患者。选择性地使用临床编码来确定所有初次减肥手术，但排除翻修或转换手术以及针对恶性或其他良性疾病的手术。主要结局指标为HES住院期间死亡率和国家统计局（ONS）出院后30天死亡率。
2009年至2016年期间，NHS共进行了41241例初次减肥手术，住院死亡29例（0.07%）。出院后30天死亡率为0.08%（41241例中的32例）。在研究期间，住院期间死亡率和出院后30天死亡率均呈下降趋势。
初次减肥手术后总体住院期间死亡率和30天死亡率仍然非常低。英国NHS内减肥手术接受率的提高是安全的。
