Halvachizadeh Sascha, Muller Domink, Baechtold Matthias, Hauswirth Fabian, Probst Pascal, Muller Markus K
Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland.
Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland.
Surg Obes Relat Dis. 2023 Apr;19(4):356-363. doi: 10.1016/j.soard.2022.10.017. Epub 2022 Oct 28.
The effects of bariatric metabolic surgery (BMS) on health and comorbidities are well-known. Socioeconomic factors have been increasingly in focus in recent investigations.
The aim of this study was to analyze the effects of BMS on predictive variables for unemployment.
This study as performed in one reference center for BMS. Patients were treated between 2011 and 2017.
The study design was a retrospective cohort study. Inclusion criteria were Roux-en-Y gastric bypass surgery, follow-up of 60 months, and complete data on employment rate. Exclusion criteria were secondary BMS, secondary referral, loss of follow-up, or patients aged 60 years and above. Patients were stratified as employed independent of part-time work and as unemployed if the patient had no current employment at the time of the visit. Follow-up visits were performed after 6, 12, 24, 48, and 60 months.
This study included 623 patients; prior to BMS, 239 (38.36%) patients were employed and 384 (61.64%) unemployed. Risk factors for baseline unemployment included increased body mass index (BMI) (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01 to 1.05; P = .010) and increased American Society of Anesthesiology (ASA) score (OR, 3.55; 95% CI, 2.56 to 4.90; P < .001). Unemployment rate dropped to 32.4% after 24 months (P < .001) and increased to 62.8% after 60 months. The BMI continuously decreased. Following BMS, the unemployment rate was no longer associated with BMI (24 months: OR, 0.97; 95% CI, 0.95 to 1.01; P = .220; 60 months: 1.04; 95% CI, 0.97 to 1.11; P = .269). The initial ASA status remained associated with unemployment (OR, 2.20; 95% CI, 1.60 to 3.01; P < .001).
BMI showed some association with the unemployment rate prior to BMI. The unemployment rate significantly decreased 24 months after BMS but increased to baseline values after 60 months. Following BMS, BMI was no longer associated with unemployment.
减重代谢手术（BMS）对健康和合并症的影响已广为人知。社会经济因素在最近的研究中越来越受到关注。
本研究的目的是分析BMS对失业预测变量的影响。
本研究在一个BMS参考中心进行。患者于2011年至2017年接受治疗。
研究设计为回顾性队列研究。纳入标准为 Roux-en-Y 胃旁路手术、60个月的随访以及就业率的完整数据。排除标准为二次BMS、二次转诊、失访或60岁及以上患者。患者被分为有工作（无论兼职与否）和失业（就诊时无当前工作）两类。随访在6、12、24、48和60个月后进行。
本研究纳入623例患者；在进行BMS之前，239例（38.36%）患者有工作，384例（61.64%）失业。基线失业的危险因素包括体重指数（BMI）升高（比值比[OR]，1.03；95%置信区间[CI]，1.01至1.05；P = 0.010）和美国麻醉医师协会（ASA）评分升高（OR，3.55；95%CI，2.56至4.90；P < 0.001）。24个月后失业率降至32.4%（P < 0.001），60个月后升至62.8%。BMI持续下降。BMS后，失业率不再与BMI相关（24个月：OR，0.97；95%CI，0.95至1.01；P = 0.220；60个月：1.04；95%CI，0.97至1.11；P = 0.269）。初始ASA状态仍与失业相关（OR，2.20；95%CI，1.60至3.01；P < 0.001）。
BMI在手术前与失业率存在一定关联。BMS后24个月失业率显著下降，但60个月后升至基线值。BMS后，BMI与失业不再相关。
