Divisao de Cirurgia, Unidade de Cirurgia Bariatrica e Metabolica, Departamento de Gastroenterologia, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Johnson & Johnson Medical Devices, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2020 Apr 6;75:e1588. doi: 10.6061/clinics/2020/e1588. eCollection 2020.
The number of bariatric procedures has significantly increased in Brazil, especially in the public Unified Health System. The present study describes health outcomes and medication use in obese patients treated in a major hospital that performs publicly funded surgery in Brazil.
A retrospective, single center study was conducted to collect real-world evidence of health outcomes and medication use in 247 obese patients (female, 82.2%) who underwent open Roux-en-Y gastric bypass. Changes in weight and body mass index (BMI), presence of apnea, hypertension, and type 2 diabetes (T2D), and medication use (hypertension, diabetes, and dyslipidemia) were assessed preoperatively and up to 24 months postoperatively. The mean cost of medications was calculated for the 12-month preoperative and 24-month postoperative periods.
During the surgery, the mean age of patients was 43.42 years (standard deviation [SD], 10.9 years), and mean BMI was 46.7 kg/m2 (SD, 6.7 kg/m2). At 24 months, significant declines were noted in weight (mean, -37.6 kg), BMI (mean, -14.3 kg/m2); presence of T2D, hypertension, and apnea (-29.6%, -50.6%, and -20.9%, respectively); and number of patients using medications (-66.67% for diabetes, -41.86% for hypertension, and -55.26% for dyslipidemia). The mean cost of medications (total costs for all medications) decreased by >50% in 12-24 postoperative months compared to that in 12 preoperative months.
Roux-en-Y gastric bypass successfully reduced weight, BMI, and comorbidities and medication use and cost at 24 months in Brazilian patients treated in the public Unified Health System.
巴西的减重手术数量显著增加，尤其是在公共统一卫生系统中。本研究描述了在巴西一家主要医院接受公共资助手术的肥胖患者的健康结果和药物使用情况。
进行了一项回顾性、单中心研究，以收集 247 名接受开放式 Roux-en-Y 胃旁路术肥胖患者（82.2%为女性）的真实世界健康结果和药物使用数据。评估了术前和术后 24 个月的体重和体重指数（BMI）变化、呼吸暂停、高血压和 2 型糖尿病（T2D）的存在情况以及药物使用（高血压、糖尿病和血脂异常）情况。计算了术前 12 个月和术后 24 个月的药物平均费用。
手术期间，患者的平均年龄为 43.42 岁（标准差[SD]为 10.9 岁），平均 BMI 为 46.7 kg/m2（SD 为 6.7 kg/m2）。24 个月时，体重（平均下降 37.6 公斤）、BMI（平均下降 14.3 kg/m2）、T2D、高血压和呼吸暂停的发生率显著下降（分别下降 29.6%、50.6%和 20.9%），以及使用药物的患者数量（糖尿病减少 66.67%、高血压减少 41.86%、血脂异常减少 55.26%）。与术前 12 个月相比，术后 12-24 个月的药物总成本（所有药物的总费用）下降超过 50%。
在巴西公共统一卫生系统中接受治疗的患者，Roux-en-Y 胃旁路术在 24 个月时成功降低了体重、BMI 和合并症以及药物使用和费用。
