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体重指数(BMI)≥70:代谢和减重手术干预的安全性和疗效的多中心机构经验。

BMI ≥ 70: A Multi-Center Institutional Experience of the Safety and Efficacy of Metabolic and Bariatric Surgery Intervention.

机构信息

Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.

Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, USA.

出版信息

Obes Surg. 2024 Sep;34(9):3165-3172. doi: 10.1007/s11695-024-07419-7. Epub 2024 Jul 24.

Abstract

PURPOSE

With the escalating prevalence of obesity, healthcare providers are increasingly managing patients with a body mass index (BMI) exceeding 70. The aim of this study was to describe the perioperative experiences of this demographic group at two institutions.

METHODS

An analysis encompassing 84 patients presenting with BMI ≥ 70 kg/m from two institutions was conducted. Data included patient demographics, 30-day postoperative outcomes, and weight-loss at different intervals (30 days, 6 months, 1 year). Additionally, rates of emergency department (ED) utilization, readmission, and reoperation in the first postoperative year were examined.

RESULTS

Most patients were black (66.7%) and female (86.9%) with a mean age of 41.7 years. The majority underwent laparoscopic sleeve gastrectomy (SG, 88.1%). Patients exhibited a marked decrease in BMI (7.84% at 30 days, 20.13% at 6 months, and 26.83% at 1 year). Average length of stay was comparable across procedure (F(3,80) = 0.016, p = .997). While 30-day complications were minimal (0.7%), 14.4% of patients experienced ED visits within 30 days, escalating to 19.6% by six months and 25% at 1 year. Readmission and reoperation rates at 1 year were 6.45% and 4.83%, respectively.

CONCLUSION

With global obesity rates rising, clinicians are being challenged to care for patients with BMI ≥ 70 kg/m. Analysis of two institutions demonstrated low rates of 30-days complications but increased readmission rates and ED utilization in this patient population. Despite increased resource utilization, the study suggests that BMI ≥ 70 kg/m alone should not be a deterrent for surgery, emphasizing the need for nuanced care in this expanding demographic.

摘要

目的

随着肥胖症患病率的不断上升,医疗保健提供者越来越多地管理身体质量指数(BMI)超过 70 的患者。本研究旨在描述这两个机构中这一人群的围手术期经历。

方法

对来自两个机构的 84 名 BMI≥70kg/m2的患者进行了分析。数据包括患者人口统计学资料、30 天术后结果以及不同时间间隔(30 天、6 个月、1 年)的体重减轻情况。此外,还检查了术后第一年急诊就诊、再入院和再次手术的发生率。

结果

大多数患者为黑人(66.7%)和女性(86.9%),平均年龄为 41.7 岁。大多数患者接受了腹腔镜袖状胃切除术(SG,88.1%)。患者的 BMI 显著下降(30 天时为 7.84%,6 个月时为 20.13%,1 年时为 26.83%)。不同手术方式的平均住院时间相似(F(3,80)=0.016,p=0.997)。虽然 30 天并发症很少(0.7%),但 14.4%的患者在 30 天内就诊于急诊,6 个月时增加到 19.6%,1 年时增加到 25%。1 年内再入院和再次手术的发生率分别为 6.45%和 4.83%。

结论

随着全球肥胖率的上升,临床医生面临着为 BMI≥70kg/m 的患者提供护理的挑战。对两个机构的分析表明,30 天并发症发生率较低,但该患者人群的再入院率和急诊就诊率增加。尽管资源利用率增加,但研究表明,BMI≥70kg/m 本身不应成为手术的障碍,强调在这一不断扩大的人群中需要进行细致的护理。

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