Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
J Natl Med Assoc. 2020 Apr;112(2):158-166. doi: 10.1016/j.jnma.2020.02.007. Epub 2020 Mar 18.
Metabolic and Bariatric Surgery (MBS) has become increasingly common as a treatment option for severely obese. We examined the association of hospital length of stay (LOS) by race-ethnicity (Hispanic, non-Hispanic white [NHW], NH black [NHB]) and MBS-procedure among Florida inpatients.
Secondary analysis of inpatient records was performed using the 2016 Florida Agency for Health Care Administrative (AHCA) data. Records of Laparoscopic Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Adjustable Gastric Banding (LAGB), and Sleeve Gastrectomy (SG) procedures based on ICD 10th edition code were analyzed. Via logistic regression analysis, the adjusted odds ratio (aOR) of longer LOS (≥2 versus < 2days) and the corresponding 95% confidence interval (CI) were calculated for racial-ethnic groups (NHW versus other groups) and MBS type (SG versus LAGB or RYGB) adjusted for age, sex, BMI, and insurance status.
The majority of the sample (N = 10,630, approximately 56% NHW, 21% NHB, 20% Hispanic, 3% Other) underwent SG (71%), followed by RYGB (24%) and LAGB (5%). Hispanic were more likely (aOR 1.27; 95% CI 1.14-1.42) and NHB were less likely (0.68; 0.61-0.75) than NHW to have longer LOS regardless of MBS type. Compared to SG, LAGB patients were more likely (2.09; 1.70-2.55) but RYGB patients were less likely (0.32; 0.29-0.36) to have longer LOS.
Although LAGB is considered the least invasive MBS, recipients tend to stay longer in hospital after adjustment for health insurance and sociodemographic factors. Medical and socioecological reasons for racial-ethnic variations in LOS relating MBS should be explored further.
代谢与减重手术（MBS）作为严重肥胖症的治疗选择已越来越普遍。我们研究了佛罗里达州住院患者的种族-族裔（西班牙裔、非西班牙裔白人[NHW]、NH 黑人[NHB]）和 MBS 手术的住院时间（LOS）与种族-族裔之间的关联。
使用 2016 年佛罗里达州卫生保健管理局（AHCA）数据对住院病历进行二次分析。根据 ICD10 版代码分析腹腔镜 Roux-en-Y 胃旁路术（RYGB）、腹腔镜可调胃带术（LAGB）和袖状胃切除术（SG）的记录。通过逻辑回归分析，计算了种族-族裔群体（NHW 与其他群体）和 MBS 类型（SG 与 LAGB 或 RYGB）之间的调整后比值比（aOR）和相应的 95%置信区间（CI），并对年龄、性别、BMI 和保险状况进行了调整。
大多数样本（N=10630，约 56%NHW、21%NHB、20%西班牙裔、3%其他）接受了 SG（71%），其次是 RYGB（24%）和 LAGB（5%）。无论 MBS 类型如何，西班牙裔患者（aOR1.27；95%CI1.14-1.42）更有可能且 NHB 患者（0.68；0.61-0.75）不太可能出现较长的 LOS。与 SG 相比，LAGB 患者（2.09；1.70-2.55）更有可能，但 RYGB 患者（0.32；0.29-0.36）不太可能出现较长的 LOS。
尽管 LAGB 被认为是最微创的 MBS，但在调整医疗保险和社会人口因素后，接受者在医院的住院时间往往更长。应进一步探讨与 MBS 相关的种族-族裔 LOS 差异的医学和社会生态学原因。
