Clinic of Medicine and Rehabilitation Møre and Romsdal Hospital Trust Aalesund Norway.
Centre for Obesity, Department of Surgery St Olav Hospital, Trondheim University Hospital Trondheim Norway.
BJS Open. 2019 Sep 30;3(6):777-784. doi: 10.1002/bjs5.50223. eCollection 2019 Dec.
Patients' perceptions of health change after bariatric surgery are complex. The aim of this study was to explore whether self-rated health (SRH), a widely used tool in public health research, might be relevant as an outcome measure after Roux-en-Y gastric bypass (RYGB) for severe obesity.
This was a single-centre retrospective study of a local quality registry. SRH score was registered at baseline and 5 years after RYGB. SRH, one of the 36 items in the quality-of-life Short Form 36 (SF-36®) questionnaire, is the answer to this single question: 'In general, would you say your health is excellent (1), very good (2), good (3), fair (4) or poor (5)?' Change in SRH was analysed in relation to change in weight, co-morbidities and quality of life after 5 years.
Of a total of 359 patients who underwent RYGB between September 2006 and February 2011, 233 (64·9 per cent) reported on SRH before and 5 years after surgery. Of these, 180 (77·3 per cent) were women, and the mean(s.d.) age was 40(9) years. Some 154 patients (66·1 per cent) reported an improvement in SRH, 60 (25·8 per cent) had no change, and SRH decreased in 19 patients (8·2 per cent). SRH in improvers was related to better scores in all SF-36® domains, whereas SRH in non-improvers was related to unchanged or worsened scores in all SF-36® domains except physical function.
Two-thirds of patients reported improved SRH 5 years after RYGB for severe obesity. In view of its simplicity, SRH may be an easy-to-use outcome measure in bariatric surgery.
患者对减重手术后健康状况的感知较为复杂。本研究旨在探讨自感健康（SRH）作为一种广泛应用于公共卫生研究的工具，在 Roux-en-Y 胃旁路术（RYGB）治疗严重肥胖症后的疗效评估中是否具有相关性。
这是一项基于本地质量登记处的单中心回顾性研究。SRH 评分在 RYGB 术前和术后 5 年进行登记。SRH 是健康状况简短调查问卷（SF-36®）36 个项目之一，答案是：“总的来说，您的健康状况是极好（1）、很好（2）、好（3）、一般（4）还是差（5）？”术后 5 年，我们分析了 SRH 的变化与体重、合并症和生活质量的变化之间的关系。
在 2006 年 9 月至 2011 年 2 月期间接受 RYGB 的 359 名患者中，有 233 名（64.9%）患者报告了手术前和术后 5 年的 SRH。其中 180 名（77.3%）为女性，平均年龄（标准差）为 40（9）岁。154 名患者（66.1%）报告 SRH 改善，60 名患者（25.8%）无变化，19 名患者（8.2%）SRH 下降。改善者的 SRH 与 SF-36®所有领域的评分提高相关，而非改善者的 SRH 与 SF-36®所有领域的评分不变或恶化相关，除了身体功能。
三分之二的患者在 RYGB 治疗严重肥胖症 5 年后报告自感健康状况改善。鉴于其简单性，SRH 可能是减重手术中一种易于使用的疗效评估指标。
