Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
Obes Facts. 2019;12(4):427-439. doi: 10.1159/000496939. Epub 2019 Aug 15.
Obesity surgery has proven successful for weight loss and the resolution of comorbidities. There is, however, little evidence on its success and the risk of complications when considering age of onset of obesity (AOO), years of obesity (YOO), preoperative body mass index (BMI), Edmonton obesity staging system (EOSS) score, and age as possible predictors of weight loss, the resolution of comorbidities, and the risk of complications.
Patients who underwent Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) from a prospective database were analyzed. Multiple regression analyses were used to predict comorbidities and their resolution, percentage excess weight loss (%EWL) and total weight loss (%TWL) 12 months after surgery, and the risk of complications using the predictors AOO, YOO, age, EOSS, and BMI.
180 patients aged 46.8 ± 11.1 years with a preoperative BMI 49.5 ± 7.5 were included. The number of preoperative comorbidities was higher with older age (β = 0.054; p = 0.023) and a greater BMI (β = 0.040; p = 0.036) but was not related to AOO and YOO. Patients with AOO as a child or adolescent were more likely to have an EOSS score of ≥2. Greater preoperative BMI was negatively associated with %EWL (β = -1.236; p < 0.001) and older age was negatively associated with %TWL (β = -0.344; p = 0.020). Postoperative complications were positively associated with EOSS score (odds ratio [OR] 1.147; p = 0.042) and BMI (OR 1.010; p = 0.020), but not with age. AOO and YOO were not related to postoperative outcome.
Greater BMI was associated with a lower %EWL and age was associated with a low %TWL. YOO and AOO did not influence outcome. Age, BMI, and EOSS score were the most important predictors for risk and success after obesity surgery. Surgery should be performed early enough for optimal outcomes.
肥胖症手术已被证明在减肥和解决合并症方面取得了成功。然而，关于肥胖症发病年龄（AOO）、肥胖症持续时间（YOO）、术前体重指数（BMI）、埃德蒙顿肥胖症分期系统（EOSS）评分和年龄作为体重减轻、合并症解决和并发症风险的预测因素的成功和并发症风险的证据很少。
分析了从前瞻性数据库中接受 Roux-en-Y 胃旁路术（RYGB）和腹腔镜袖状胃切除术（LSG）的患者。使用多元回归分析预测合并症及其解决、术后 12 个月的体重减轻百分比（%EWL）和总体重减轻（%TWL），以及使用预测因子 AOO、YOO、年龄、EOSS 和 BMI 预测并发症风险。
纳入了 180 名年龄为 46.8 ± 11.1 岁、术前 BMI 为 49.5 ± 7.5 的患者。年龄较大（β=0.054；p=0.023）和 BMI 较高（β=0.040；p=0.036）与术前合并症数量增加有关，但与 AOO 和 YOO 无关。AOO 为儿童或青少年的患者更有可能 EOSS 评分为≥2。较大的术前 BMI 与%EWL 呈负相关（β=-1.236；p<0.001），年龄较大与%TWL 呈负相关（β=-0.344；p=0.020）。术后并发症与 EOSS 评分（比值比[OR]1.147；p=0.042）和 BMI（OR 1.010；p=0.020）呈正相关，但与年龄无关。AOO 和 YOO 与术后结果无关。
较大的 BMI 与较低的%EWL 相关，年龄与较低的%TWL 相关。YOO 和 AOO 对结果没有影响。年龄、BMI 和 EOSS 评分是肥胖症手术后风险和成功的最重要预测因素。为了获得最佳结果，手术应尽早进行。
