BACKGROUND:Laparoscopic gastric bypass surgery (LGBS) has become the most widely used bariatric procedure due to its beneficial long-term outcomes for patients with morbid obesity. However, it is unclear whether racial differences in admission for LGBS have changed over time compared to racial differences in all other admissions. We aimed to investigate the trends and differences in the use of LGBS among white, African-American, and Hispanic patients from 2002 to 2008. METHODS:We performed a secondary analysis of data on obese adult patients operated between 2002 and 2008, using the Nationwide Inpatient Sample (NIS) database. The probability of being admitted for LGBS was estimated using logistic regression with race, year, and year by race interaction as predictors, controlling for numerous patient and hospital characteristics. RESULTS:Among 1,704,972 obese hospitalized patients captured through NIS from 2002 to 2008, 2.6 % underwent LGBS (2.8 % Whites, 1.7 % African-Americans, and 2.6 % Hispanics). In adjusted analysis, obese African-American (OR 0.48, p < 0.001) and Hispanic patients (OR 0.59, p < 0.001) were less likely to be admitted for LGBS than white patients in 2002. Race-year interactions showed that the odds of African-Americans undergoing LGBS significantly increased from 2002 to 2008 compared with Whites (annual OR 1.03, p < 0.001) while no such increase was detected for Hispanics (annual OR 1.02, p = 0.11). In 2008, African-American (OR 0.58, p < 0.001) and Hispanic patients (OR 0.65, p < 0.001) still had lower odds than white patients. CONCLUSIONS:This is the first study showing that the difference in the use of LGBS between obese African-American and white patients declined between 2002 and 2008. However, LGBS use still remained significantly lower for both African-American and Hispanic patients in 2008 compared with white patients.

译文

背景:腹腔镜胃旁路手术(LGBS)由于对病态肥胖患者有益的长期疗效,已成为减肥手术中使用最广泛的方法。但是,目前尚不清楚与所有其他录取中的种族差异相比,LGBS录取中的种族差异是否随时间变化。我们旨在调查2002年至2008年间白人,非裔美国人和西班牙裔患者使用LGBS的趋势和差异。
方法:我们使用全国住院患者样本(NIS)数据库对2002年至2008年间肥胖成人患者的数据进行了二次分析。使用种族,年份和年份(通过种族相互作用作为预测因素)进行逻辑回归,以控制众多患者和医院的特征为基础,估算了被纳入LGBS的可能性。
结果:从2002年到2008年,通过NIS捕获的1,704,972例肥胖住院患者中,有2.6%接受了LGBS治疗(2.8%的白人,1.7%的非裔美国人和2.6%的西班牙裔)。在校正后的分析中,2002年,肥胖的非洲裔美国人(OR 0.48,p <0.001)和西班牙裔患者(OR 0.59,p <0.001)与白人患者相比,LGBS入院的可能性较小。与白人相比,经历LGBS的非裔美国人在2002年至2008年间显着增加(年度OR 1.03,p <0.001),而西班牙裔未发现此类增加(年度OR 1.02,p = 0.11)。 2008年,非裔美国人(OR 0.58,p <0.001)和西班牙裔患者(OR 0.65,p <0.001)的患病几率仍低于白人患者。
结论:这是第一项研究,表明肥胖的非洲裔美国人和白人患者使用LGBS的差异在2002年至2008年之间有所下降。但是,与2008年相比,非洲裔美国人和西班牙裔患者的LGBS使用率仍然明显低于2008年。白人患者。

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