Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden.
Department of Community Medicine and Public Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Obes Surg. 2019 Nov;29(11):3569-3576. doi: 10.1007/s11695-019-04028-7.
Patients with low socioeconomic status have been reported to experience poorer outcome after several types of surgery. The influence of socioeconomic factors on health-related quality-of-life (HRQoL) after bariatric surgery is unclear.
Patients operated with a primary laparoscopic gastric bypass procedure in Sweden between 2007 and 2015 were identified in the Scandinavian Obesity Surgery Register. Patients with a completed assessment of health-related quality-of-life based on the Obesity-related Problem Scale (OP Scale) were included in the study. Socioeconomic status was based on data from Statistics Sweden.
A total of 13,723 patients (32% of the 43,096 operated during the same period), with complete OP scores at baseline and two years after surgery, were included in the study. Age, lower preoperative BMI, male gender, higher education, professional status and disposable income as well as not receiving social benefits (not including retirement pension), and not a first- or second-generation immigrant, were associated with a higher postoperative HRQoL. Patients aged 30-60 years, with lower BMI, higher socioeconomic status, women and those born in Sweden by Swedish parents experienced a higher degree of improvement in HRQoL. Postoperative weight-loss was associated with higher HRQoL (unadjusted B 16.3, 95%CI 14.72-17.93, p < 0.0001).
At 2 years, a strong association between weight loss and improvement in HRQoL was seen, though several factors influenced the degree of improvement. Age, sex, preoperative BMI and socioeconomic status all influence the postoperative HRQoL as well as the improvement in HRQoL after laparoscopic gastric bypass surgery.
据报道，社会经济地位较低的患者在接受多种类型手术后的预后较差。社会经济因素对减重手术后健康相关生活质量（HRQoL）的影响尚不清楚。
在瑞典，2007 年至 2015 年间，对接受腹腔镜胃旁路手术的患者进行了识别，这些患者的信息都被记录在斯堪的纳维亚肥胖手术登记处。在研究中，我们纳入了根据肥胖相关问题量表（OP Scale）完成健康相关生活质量评估的患者。社会经济地位基于瑞典统计局的数据。
共纳入 13723 名患者（同期手术患者的 32%），这些患者在基线和手术后两年均完成了 OP 评分。年龄、较低的术前 BMI、男性、较高的教育程度、职业地位和可支配收入，以及没有接受社会福利（不包括养老金）和非第一代或第二代移民的患者，与术后较高的 HRQoL 相关。30-60 岁、BMI 较低、社会经济地位较高、女性和出生于瑞典、父母为瑞典人的患者，其 HRQoL 改善程度更高。术后体重减轻与较高的 HRQoL 相关（未调整的 B 值为 16.3，95%CI 为 14.72-17.93，p<0.0001）。
在术后 2 年，体重减轻与 HRQoL 的改善呈强相关，尽管有几个因素影响了改善程度。年龄、性别、术前 BMI 和社会经济地位均影响腹腔镜胃旁路手术后的 HRQoL 和 HRQoL 的改善程度。
