Raoof Mustafa, Szabo Eva, Karlsson Jan, Näslund Erik, Cao Yang, Näslund Ingmar
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Surg Obes Relat Dis. 2020 Sep;16(9):1249-1257. doi: 10.1016/j.soard.2020.04.041. Epub 2020 May 12.
Obesity continues to increase in the world. It is strongly associated with morbidity, mortality, and decrease of health-related quality of life (HRQoL). Surgery is the most effective treatment for obesity, resulting in sustained weight loss and improvements of HRQoL. The aim of this study was to examine whether other factors, apart from weight loss, are associated with improvement in HRQoL scores between the preoperative visit and the 5-year follow-up.
To examine whether there are factors besides weight loss that affect the improvement of HRQoL from before to 5 years after gastric bypass surgery.
Large, nationwide, observational study with national quality and research registry.
Patients operated with a primary gastric bypass in Sweden between January 2008 and December 2012 were identified in the Scandinavian Obesity Surgery Register. Patients with HRQoL data available at both baseline and 5 years after surgery were included. Two HRQoL instruments, the RAND Short form-36 and the obesity-related problems scale, were used in the study.
The study sample comprised 6998 patients (21% men). Differences in HRQoL change according to sex were minor. Younger patients showed greater improvements in physical health scales. In general linear regression model analyses, age and weight loss correlated significantly with improvement in HRQoL after 5 years. Patients treated medically for depression preoperatively (13%) experienced less improvement in HRQoL than patients without such treatment. Patients with postoperative complications (26%) had significantly less improvements in all aspects of HRQoL compared with those without any form of postoperative complication.
The study confirmed the importance of weight loss for improvement in HRQoL after bariatric surgery. Preoperative medication for depression and suffering a complication during the 5-year follow-up period were associated with less improvement in HRQoL.
肥胖在全球范围内持续增加。它与发病率、死亡率以及健康相关生活质量（HRQoL）的下降密切相关。手术是治疗肥胖最有效的方法，可实现持续减重并改善HRQoL。本研究的目的是探讨除体重减轻外，其他因素是否与术前访视至5年随访期间HRQoL评分的改善相关。
探讨除体重减轻外，是否存在其他因素影响胃旁路手术后至5年期间HRQoL的改善。
一项基于全国质量和研究登记处的大型全国性观察性研究。
在斯堪的纳维亚肥胖手术登记处识别出2008年1月至2012年12月期间在瑞典接受初次胃旁路手术的患者。纳入在基线和术后5年均有HRQoL数据的患者。本研究使用了两种HRQoL工具，即兰德36项简式健康调查和肥胖相关问题量表。
研究样本包括6998名患者（21%为男性）。HRQoL变化在性别上的差异较小。年轻患者在身体健康量表上的改善更大。在一般线性回归模型分析中，年龄和体重减轻与5年后HRQoL的改善显著相关。术前接受抑郁症药物治疗的患者（13%）在HRQoL方面的改善低于未接受此类治疗的患者。术后出现并发症的患者（26%）与未出现任何形式术后并发症的患者相比，在HRQoL的各个方面改善均显著较少。
该研究证实了减重对减肥手术后HRQoL改善的重要性。术前抑郁症药物治疗以及在5年随访期间出现并发症与HRQoL改善较少相关。
