Equitable Access, Lasting Results: The Influence of Socioeconomic Environment on Bariatric Surgery Outcomes.

IF 2.9 3区医学 Q1 SURGERY Obesity Surgery Pub Date : 2024-10-28 DOI:10.1007/s11695-024-07529-2

Carolina Sager La Ganga, Iñigo García-Sanz, Elena Carrillo López, Víctor Navas-Moreno, Mónica Marazuela, Álvaro Gancedo-Quintana, Cristina Marín-Campos, Raffaele Carraro, Fernando Sebastián-Valles

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Abstract

Purpose: Low socioeconomic status (SES) correlates with higher obesity rates and challenges in accessing treatments like bariatric surgery (BS). This study aims to assess SES's influence on medium-term BS outcomes in a setting of universal healthcare, ensuring equitable treatment access.

Material and methods: We conducted a retrospective analysis of 193 BS patients (1997-2018) at a tertiary care hospital. Weight loss was expressed as change in % total weight loss (%TWL) and excess body weight (EBW) loss. Successful BS was defined as > 50% EBW loss. SES was gauged using quartiles of the Spanish Deprivation Index. A multivariable Cox regression model evaluated SES impact on BS success over follow-up.

Results: The mean follow-up was 6.9 ± 4.6 years; patients averaged 43.9 ± 11.8 years, with 29.7% men. Preoperative BMI was 48.2 ± 8.2 kg/m². At follow-up, BMI was 33.9 ± 6.6 kg/m², with 29.3 ± 12.02% of %TWL. No SES quartile differences in BS success were noted at follow-up (log rank p = 0.960). Cox regression revealed no SES disparities in BS outcomes post-adjustment. However, female sex (HR 1.903; p = 0.009) and diabetes mellitus (HR = 0.504; p = 0.010) correlated with weight-related outcomes.

Conclusion: In a universal healthcare system with equitable treatment access, medium-term BS outcomes remain consistent irrespective of patients' socioeconomic status.

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公平的机会，持久的效果：社会经济环境对减肥手术结果的影响。

目的：低社会经济地位（SES）与较高的肥胖率和获得减肥手术（BS）等治疗的挑战相关。本研究旨在评估社会经济地位对全民医保背景下减肥手术中期疗效的影响，以确保公平的治疗机会：我们对一家三级医院的 193 名减肥手术患者（1997-2018 年）进行了回顾性分析。体重减轻以总体重减轻率（%TWL）和超重率（EBW）的变化表示。成功的 BS 定义为 EBW 减少 > 50%。SES采用西班牙贫困指数的四分位数进行衡量。多变量 Cox 回归模型评估了 SES 对随访期间 BS 成功率的影响：平均随访时间为 6.9 ± 4.6 年；患者平均年龄为 43.9 ± 11.8 岁，男性占 29.7%。术前体重指数为 48.2 ± 8.2 kg/m2。随访时，BMI 为 33.9 ± 6.6 kg/m2，TWL%为 29.3 ± 12.02%。随访时，BS 成功率无 SES 四分位差异（对数秩 p = 0.960）。Cox 回归显示，调整后的 BS 结果没有 SES 差异。然而，女性性别（HR 1.903；p = 0.009）和糖尿病（HR = 0.504；p = 0.010）与体重相关结果相关：结论：在治疗机会均等的全民医疗保健系统中，无论患者的社会经济地位如何，中期 BS 结果都是一致的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.