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65 岁及以上患者在 COVID-19 大流行期间接受减肥手术的安全性。

Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic.

机构信息

Upper GI unit, Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Bordesley Green East, Birmingham, West Midlands, B9 5SS, UK.

Healthier Weight, Birmingham, UK.

出版信息

Obes Surg. 2022 Jul;32(7):1-13. doi: 10.1007/s11695-022-06067-z. Epub 2022 May 5.

Abstract

BACKGROUND

Age ≥ 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort.

METHODS

We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups - patients ≥ 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality.

RESULTS

There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 ± 2.5 years, 119.5 ± 24.5 kg, and 43 ± 7 in Group I and 39.8 ± 11.3 years, 117.7±20.4 kg, and 43.7 ± 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I (11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups.

CONCLUSIONS

Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those ≥ 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups.

摘要

背景

年龄≥65 岁被认为是减肥手术的相对禁忌症。随着 2019 年冠状病毒病(COVID-19)继续在全球范围内肆虐,高龄也是 COVID-19 不良结局的公认危险因素。本研究旨在评估在 COVID-19 大流行期间,与年轻患者相比,这一年龄组接受减肥手术(BS)的安全性。

方法

我们进行了一项前瞻性国际研究,纳入了 2020 年 5 月 1 日至 10 月 31 日期间接受 BS 的患者。患者分为两组:年龄≥65 岁(I 组)和年龄<65 岁(II 组)。比较两组患者的 30 天发病率和死亡率。

结果

I 组有 149 例患者,II 组有 6923 例患者。I 组患者的平均年龄、术前体重和 BMI 分别为 67.6±2.5 岁、119.5±24.5kg 和 43±7,II 组患者的平均年龄、术前体重和 BMI 分别为 39.8±11.3 岁、117.7±20.4kg 和 43.7±7。I 组约 95%的患者至少有一种合并症,而 II 组只有 68%的患者(p<0.001)。I 组的 30 天发病率(11.4%)明显高于 II 组(6.6%)(p=0.022)。然而,两组间 30 天死亡率和 COVID-19 感染率无显著差异。

结论

与年龄<65 岁的患者相比,COVID-19 大流行期间,年龄≥65 岁的患者接受减肥手术与更高的并发症发生率相关。然而,两组间死亡率和术后 COVID-19 感染率无显著差异。

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本文引用的文献

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The World Health Organization (WHO) approach to healthy ageing.世界卫生组织(WHO)的健康老龄化方法。
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