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在接受减肥外科手术的医疗保险受益人中,早期死亡率
David R Flum1, Leon Salem, Jo Ann Broeckel Elrod
1Department of Surgery, University of Washington, Seattle, Wash 98195-7183, USA. daveflum@u.washington.edu
JAMA
|October 20, 2005
概括
减肥手术后的早期死亡风险对于医疗保险受益者来说高于以前所认为的. 老年患者,男性和外科医生数量较少的患者面临着显著增加的死亡风险.
科学领域:
- 腹部外科手术的结果
- 老年外科手术风险评估
- 医疗服务研究 医疗服务研究
背景情况:
- 之前的病例系列表明低周围手术死亡率 (0.5%) 减肥手术.
- 高风险人群和普通人群的死亡率仍然未知.
研究的目的:
- 评估正在接受减肥手术的医疗保险受益人早期死亡风险.
- 为了确定与腹腔外科手术后死亡相关的危险因素,特别是年龄.
主要方法:
- 从1997年至2002年对付费医疗保险受益人的回顾性队列研究.
- 在减肥手术后对30天,90天和1年的全因死亡率的分析.
- 根据年龄,性别和并发症指数进行统计调整.
主要成果:
- 16,155名患者接受了减肥手术;30天,90天和1年的死亡率分别为2.0%,2.8%和4.6%.
- 在男性和女性,65岁以上的患者和年轻患者中观察到较高的死亡率.
- 75岁以上的患者90天死亡风险增加了5倍;较低的外科手术量与1.6倍的风险增加有关.
结论:
- 在医疗保险受益人群中,减肥手术后的早期死亡率高于之前报告的.
- 高龄,男性性别和外科医生数量较少是死亡率的重要风险因素.
- 老年患者 (65岁以上) 在早期术后期面临明显升高的死亡风险.
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