国家减肥优先级工具能预测健康结果吗?
Lisa Chung1, Gajan Srikumar1, Christin Coomarasamy2
1Department of General Surgery, Middlemore Hospital, Te Whatu Ora Counties Manukau, Auckland, New Zealand.
ANZ journal of surgery
|August 22, 2023
概括
国家减肥优先级工具 (NBPT) 没有预测体重减轻,但在改善糖尿病和高血压等并发病症方面表现有前途. 毛利人和帕西菲卡人的得分更高表明,在减肥手术优先考虑方面,公平获取的可能性很大.
科学领域:
- 腹部外科手术的结果
- 健康 公平 研究 健康 公平 研究
- 临床优先级工具 临床优先级工具
背景情况:
- 国家腹重点化工具 (NBPT) 是在新西兰开发的,但缺乏与真实世界患者数据的验证.
- 这项研究旨在评估NBPT在接受减肥手术的患者的各种健康结果上的预测有效性.
研究的目的:
- 为了评估NBPT在手术后18个月的总体重减轻率 (%TWL) 的预测准确度.
- 确定NBPT分数与关键健康指标 (包括HbA1c,脂质,阻塞性睡眠呼吸暂停 (OSA),高血压和关节炎药物使用) 的改善之间的相关性.
- 通过检查NBPT得分与人口统计学因素 (如年龄,性别和种族) 之间的关系来评估获得的公平性.
主要方法:
- 一项观察性研究包括在2014年12月至2016年12月期间连续294名接受选择性减肥手术的患者.
- 用NBPT来确定优先级,在18个月的随访期间收集了%TWL,HbA1c,脂质,OSA解析,高血压解析和药物使用的数据.
- 进行了统计分析,以将NBPT分数与健康结果和人口统计数据相关联.
主要成果:
- 在NBPT优先级得分和%TWL之间没有发现显著的相关性 (相关性-0.09,P=0.14).
- 在该工具的"效益评分"组件和%TWL之间观察到正相关性 (相关性为0.25,P<0.0001).
- 在优先级分数和HbA1c (0.28),OSA分辨率 (0.20) 和高血压分辨率 (0.20) 的改善之间发现了显著的相关性.
- 与新西兰欧洲人相比,毛利人和帕西菲卡患者的NBPT分数显著更高 (P=0.0023),表明优先级的潜在种族差异.
结论:
- NBPT可能不是%TWL的可靠预测指标,但显示了改善糖尿病,OSA和高血压等并发症的潜在预测有效性.
- 毛利人和帕西菲卡人群中NBPT得分较高,这些人群患肥胖和并发病率较高,这表明该工具可以用于促进公平获得减肥手术.
- 建议进一步完善NBPT以提高其预测结果的能力,并确保公平的患者选择.
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