Interest in bariatric surgery among obese patients with obstructive sleep apnea.

Autor:	Dudley KA; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, United States. Electronic address: kdudley@partners.org., Tavakkoli A; Center for Weight Management and Metabolic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, United States., Andrews RA; Division of General, Minimally Invasive and Acute Care Surgery, North Shore-LIJ Lenox Hill Hospital, New York, New York, United States., Seiger AN; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, United States., Bakker JP; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, United States., Patel SR; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts, United States.
Jazyk:	angličtina
Zdroj:	Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery [Surg Obes Relat Dis] 2015 Sep-Oct; Vol. 11 (5), pp. 1146-51. Date of Electronic Publication: 2015 Jan 14.
DOI:	10.1016/j.soard.2015.01.006
Abstrakt:	Background: Standard obstructive sleep apnea (OSA) therapies are poorly tolerated. Bariatric surgery is a potential alternative but the level of interest in this intervention among OSA patients is unknown. Objectives: Determine the proportion of OSA patients who would be interested in bariatric surgery. Setting: Sleep clinics, United States. Methods: Consecutive adult patients with untreated severe OSA and a body mass index of 35-45 kg/m(2) were approached. Patients at low perioperative risk and no urgent indication for OSA treatment were invited to a separate informational visit about bariatric surgery as primary treatment for OSA. Results: Of 767 eligible patients, 230 (30.0%) were not at low perioperative risk, 49 (6.4%) had drowsy driving, and 16 (2.1%) had no insurance coverage for bariatric surgery. Of the remaining 482 patients, over one third (35.5%) were interested in bariatric surgery. Surgical interest was 47.2% in women versus 27.6% in men (P<0.01) and 67.3% in diabetics versus 31.0% in nondiabetics (P<0.01). In multivariable adjusted models, female gender (odds ratio 1.89, 95% CI [1.10-3.25]) and diabetes (odds ratio 3.97, 95% CI [1.97-8.01]) remained highly predictive of bariatric surgery interest. Conclusions: Nearly two thirds of obese patients with severe OSA are good candidates for bariatric surgery. Among candidates, over one third are interested in this treatment. Interest rates are highest among women and diabetics, indicating that metabolic improvements continue to be a major driver of surgery even in patients with severe OSA. Given patient interest, the role of bariatric surgery should be routinely discussed with obese OSA patients. (Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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