Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.
Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, New York.
Surg Obes Relat Dis. 2021 Feb;17(2):249-255. doi: 10.1016/j.soard.2020.10.015. Epub 2020 Oct 16.
Sociodemographic disparities in terms of access to bariatric surgery are ongoing.
This study aimed to examine the trends for bariatric interventions based on patient characteristics from 2011 to 2018 in the state of New York.
Administrative statewide database.
This study used the New York Statewide Planning and Research Cooperative System database to identify all patients with obesity who underwent Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB) between 2011 and 2018. The trends were studied for the types of bariatric procedures performed across different patient characteristics, including median household income as determined based on ZIP code. A multivariable logistic regression analysis was performed to compare the yearly trends.
We identified 111,793 patients who underwent bariatric surgery. The number of bariatric procedures increased from 9304 in 2011 to 16,946 in 2018. RYGB was the most performed bariatric operation in 2011, but was replaced by SG from 2013 to 2018. Patients living in the highest decile median household income ZIP code areas had the highest increase in SG (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.46-1.55; P < .0001) and the largest decrease in LAGB (OR, .53; 95% CI, .51-.56; P = .0007).
The use of bariatric surgery increased significantly from 2011 to 2018. However, the disproportionately and substantially increased use of SG and the decreased use of LAGB in patients living in wealthier areas suggest that disparity in the use of bariatric interventions still exists. Public health efforts should be made to equalize access to bariatric surgery.
在获得减肥手术方面，社会人口统计学方面的差异仍然存在。
本研究旨在根据 2011 年至 2018 年纽约州患者特征，检查减肥干预措施的趋势。
全州行政数据库。
本研究使用纽约州全州规划和研究合作系统数据库，确定了 2011 年至 2018 年间接受 Roux-en-Y 胃旁路术（RYGB）、腹腔镜袖状胃切除术（SG）和腹腔镜可调胃带术（LAGB）的所有肥胖患者。研究了不同患者特征（包括根据邮政编码确定的中位数家庭收入）下进行的减肥手术类型的趋势。采用多变量逻辑回归分析比较每年的趋势。
我们确定了 111793 名接受减肥手术的患者。减肥手术的数量从 2011 年的 9304 例增加到 2018 年的 16946 例。RYGB 是 2011 年最常进行的减肥手术，但从 2013 年到 2018 年被 SG 取代。居住在中位数家庭收入最高十分位数邮政编码地区的患者，SG 的增长幅度最大（优势比 [OR]，1.51；95%置信区间 [CI]，1.46-1.55；P <.0001），LAGB 的减少幅度最大（OR，.53；95% CI，.51-.56；P =.0007）。
从 2011 年到 2018 年，减肥手术的使用显著增加。然而，在富裕地区的患者中，SG 的使用不成比例且大幅增加，而 LAGB 的使用减少，表明减肥干预措施的使用仍存在差异。应采取公共卫生措施，以平等获得减肥手术的机会。
