Warwick Medical School, Coventry, UK.
University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK.
Obes Surg. 2019 Oct;29(10):3246-3251. doi: 10.1007/s11695-019-03977-3.
Over 2 million people in England were estimated to be eligible for bariatric surgery in 2006. In 2014, clinical guidelines were updated, widening potential eligibility, meanwhile, obesity prevalence rose. However, numbers receiving surgery decreased, and concerns exist of inequalities in access between population groups. This study is aimed at estimating the number of adults eligible for surgery in England and to compare demographics with those that receive surgery.
BMI and comorbidity status were used to determine eligibility for bariatric surgery within participants of the 2014 Health Survey for England dataset (6938 adults), based on the National Institute of Health and Care Excellence guidelines. Results were scaled up using national population estimates. The demographics of eligible participants were compared against 2014/2015 hospital episode statistics for sex and age group using a chi-squared analysis.
Of the total population of England, 7.78% (95% CI 7.1-8.6%), or 3,623,505 people, could have been eligible for bariatric surgery in 2014; nearly a million more than if previous guidelines applied. Eligibility peaked at ages 45-54, with most in the 35-64 age group (58.9%). 58.4% of those eligible were women. Patients receiving surgery were far more likely to be female than male (76.1%) and the distribution skewed towards younger ages when compared with those eligible.
Bariatric surgery may benefit many people in England; significant investment is required so that service provision is adequate for demand. Differences between demographics of those eligible and receiving surgery may be explainable; however, the potential health inequality should be investigated.
据估计，2006 年英国有超过 200 万人符合接受减重手术的条件。2014 年，临床指南进行了更新，扩大了潜在的资格范围，与此同时，肥胖症的患病率也有所上升。然而，接受手术的人数却有所减少，人们对不同人群之间获得手术机会的不平等现象表示担忧。本研究旨在评估英国有多少成年人符合手术条件，并比较符合手术条件者和接受手术者的人口统计学特征。
根据国家卫生与保健卓越研究所（NICE）的指南，使用 BMI 和合并症状况来确定 2014 年英格兰健康调查（英格兰数据集）中参与者（6938 名成年人）接受减重手术的资格。结果根据全国人口估计进行了扩展。使用卡方分析比较了符合条件的参与者的人口统计学特征与 2014/2015 年医院病例统计数据中的性别和年龄组。
在英国总人口中，2014 年有 7.78%（95%CI7.1-8.6%），即 3623505 人可能有资格接受减重手术；如果按照之前的指南，这一数字将增加近 100 万。在 45-54 岁年龄组，符合条件的人数最多，为 58.9%，其中大多数人在 35-64 岁年龄组。有资格接受手术的患者中，女性占 58.4%。与男性相比，接受手术的患者中女性的可能性要大得多（76.1%），与符合条件的患者相比，年龄分布偏向年轻化。
减重手术可能使英国许多人受益；需要进行大量投资，以使服务提供能够满足需求。符合条件者和接受手术者的人口统计学特征之间的差异可能是可以解释的；然而，应该调查潜在的健康不平等现象。
