Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, Virginia.
Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland.
J Womens Health (Larchmt). 2020 Apr;29(4):585-595. doi: 10.1089/jwh.2019.7947. Epub 2020 Feb 20.
To examine patterns and outcomes of bariatric surgeries, including Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB), among women diagnosed with polycystic ovarian syndrome (PCOS). Retrospective cohort study using 1998-2011 Nationwide Inpatient Sample data. A total of 52,668 hospital discharge records met eligibility criteria among PCOS women, 18-49 years. Of those, 17,759 had an obesity/overweight diagnosis and 4310 underwent bariatric surgery. Furthermore, 3086 underwent RYGB ( = 2411), LSG ( = 126), or LAGB ( = 549), and were compared to 78,931 non-PCOS controls. Multiple regression models were constructed to examine patient- and hospital-level predictors of obesity/overweight and bariatric surgery, as well as type of bariatric surgery (RYGB, LSG, or LAGB) as a predictor of in-hospital outcomes and PCOS status. The prevalence of obesity/overweight (≈34%) among women diagnosed with PCOS, and of bariatric surgery (≈24%) among women diagnosed with PCOS and obese/overweight varied by patient- and hospital-level characteristics. Women having PCOS and overweight/obesity, who underwent LSG or LAGB, had shorter hospital stay, reduced hospital charges, and better disposition at discharge compared to those who underwent RYGB. PCOS cases and non-PCOS controls experienced similar treatment selection and in-hospital outcomes after bariatric surgery. Also, PCOS cases and non-PCOS controls experienced similar in-hospital outcomes after undergoing RYGB, LSG, or LAGB. Compared to RYGB, LSG and LAGB resulted in improved in-hospital outcomes among obese/overweight PCOS and non-PCOS patients. Further research is needed to examine health care disparities in the context of PCOS, obesity/overweight, and bariatric surgery.
为了研究多囊卵巢综合征（PCOS）女性患者中减肥手术（包括 Roux-en-Y 胃旁路术 [RYGB]、腹腔镜袖状胃切除术 [LSG] 和腹腔镜可调胃束带术 [LAGB]）的模式和结果，我们进行了一项回顾性队列研究，使用了 1998 年至 2011 年全国住院患者样本数据。在符合条件的 PCOS 女性患者（18-49 岁）中，共有 52668 例住院记录，其中 17759 例肥胖/超重，4310 例行减肥手术。此外，3086 例行 RYGB（2411 例）、LSG（126 例）或 LAGB（549 例），并与 78931 例非 PCOS 对照组进行比较。构建了多回归模型，以检查患者和医院水平的肥胖/超重和减肥手术的预测因素，以及减肥手术类型（RYGB、LSG 或 LAGB）作为住院结果和 PCOS 状态的预测因素。患有 PCOS 的女性中肥胖/超重的患病率（≈34%），以及患有 PCOS 和肥胖/超重的女性中减肥手术的患病率（≈24%）因患者和医院水平的特征而异。与 RYGB 相比，行 LSG 或 LAGB 的 PCOS 合并超重/肥胖患者的住院时间更短、住院费用更低，出院时的转归更好。减肥手术后，PCOS 病例和非 PCOS 对照组经历了类似的治疗选择和住院结果。此外，PCOS 病例和非 PCOS 对照组在接受 RYGB、LSG 或 LAGB 后经历了相似的住院结果。与 RYGB 相比，LSG 和 LAGB 改善了肥胖/超重的 PCOS 和非 PCOS 患者的住院结果。需要进一步研究，以在 PCOS、肥胖/超重和减肥手术的背景下检查医疗保健的差异。
