Bariatric and Metabolic International Surgery Center, Department of General Surgery, E-Da Hospital, No. 1, Yida Rd., Yanchao Dist., Kaohsiung City, 824, Taiwan, Republic of China.
Division of General Surgery, E-Da Hospital, Kaohsiung City, Taiwan.
Obes Surg. 2021 Feb;31(2):499-507. doi: 10.1007/s11695-020-05001-5. Epub 2020 Sep 28.
This study aims to determine whether bariatric surgery (BS) decreases the risk of respiratory tract infections (RTIs) in obese patients.
This retrospective, population-based, matched cohort study utilized data from the Taiwan National Health Insurance Research Database. All patients 18 to 55 years of age with obesity diagnosed between 2005 and 2010 were enrolled. Patients were separated into two groups based on whether they underwent BS. Two groups were selected using 1:1 propensity score matching according to age, sex, and comorbidities. The general population was also enrolled for comparison. The primary endpoint was the incidence of RTIs, including pneumonia, influenza, and bronchitis. All patients were followed up until the end of 2013, the primary endpoint, or death.
Compared to the non-surgery group, the BS group was at significantly lower risk for RTIs (aHR 0.432, 95% CI 0.340-0.549, p < 0.001) with shorter length of hospital stay (LOH) and lower cost. Regardless of the RTI-related mortality, pneumonia, influenza, and bronchitis rates, BS did have significant protective effects on the non-surgery group. Compared to the general population, the BS group was at higher risk for RTIs (aHR 3.601, 95% CI 2.742-4.728, p < 0.001) with similar LOH and lower cost.
Patients with obesity who underwent BS were at significantly lower risk for RTIs than obese patients who did not undergo BS but were at higher risk for RTIs than the general population. BS may result in a long-term reduction of the RTI risk.
本研究旨在确定减重手术（BS）是否降低肥胖患者发生呼吸道感染（RTI）的风险。
本回顾性、基于人群的匹配队列研究利用了来自台湾全民健康保险研究数据库的数据。所有 2005 年至 2010 年间诊断为肥胖的 18 至 55 岁患者均纳入本研究。根据是否接受 BS 将患者分为两组。根据年龄、性别和合并症使用 1:1 倾向评分匹配选择两组。还纳入一般人群进行比较。主要终点是 RTI 的发生率，包括肺炎、流感和支气管炎。所有患者均随访至 2013 年底、主要终点或死亡。
与非手术组相比，BS 组发生 RTI 的风险显著降低（aHR 0.432，95%CI 0.340-0.549，p<0.001），住院时间（LOH）更短，成本更低。无论 RTI 相关死亡率如何，BS 对非手术组均具有显著的保护作用。与一般人群相比，BS 组发生 RTI 的风险更高（aHR 3.601，95%CI 2.742-4.728，p<0.001），但 LOH 相似，成本更低。
与未接受 BS 的肥胖患者相比，接受 BS 的肥胖患者发生 RTI 的风险显著降低，但与一般人群相比，发生 RTI 的风险更高。BS 可能会长期降低 RTI 的风险。
