Preventive Health Screening in Veterans Undergoing Bariatric Surgery.

Autor: Stoltz DJ; Department of Surgery, Stanford University School of Medicine, Stanford, California. Electronic address: djstoltz@stanford.edu., Liebert CA; Department of Surgery, Stanford University School of Medicine, Stanford, California; Surgical Services, VA Palo Alto Health Care System, Palo Alto, California., Seib CD; Department of Surgery, Stanford University School of Medicine, Stanford, California; Surgical Services, VA Palo Alto Health Care System, Palo Alto, California; Stanford-Surgery Policy Improvement Research Education (S-SPIRE) Center, Stanford, California., Bruun A; Surgical Services, VA Palo Alto Health Care System, Palo Alto, California., Arnow KD; Stanford-Surgery Policy Improvement Research Education (S-SPIRE) Center, Stanford, California., Barreto NB; Stanford-Surgery Policy Improvement Research Education (S-SPIRE) Center, Stanford, California., Pratt JS; Department of Surgery, Stanford University School of Medicine, Stanford, California; Surgical Services, VA Palo Alto Health Care System, Palo Alto, California., Eisenberg D; Department of Surgery, Stanford University School of Medicine, Stanford, California; Surgical Services, VA Palo Alto Health Care System, Palo Alto, California; Stanford-Surgery Policy Improvement Research Education (S-SPIRE) Center, Stanford, California.
Jazyk: angličtina
Zdroj: American journal of preventive medicine [Am J Prev Med] 2022 Dec; Vol. 63 (6), pp. 979-986. Date of Electronic Publication: 2022 Sep 11.
DOI: 10.1016/j.amepre.2022.06.014
Abstrakt: Introduction: Individuals with obesity are vulnerable to low rates of preventive health screening. Veterans with obesity seeking bariatric surgery are also hypothesized to have gaps in preventive health screening. Evaluation in a multidisciplinary bariatric surgery clinic is a point of interaction with the healthcare system that could facilitate improvements in screening.
Methods: This is a retrospective cohort study of 381 consecutive patients undergoing bariatric surgery at a Veterans Affairs Hospital from January 2010 to October 2021. Age- and sex-appropriate health screening rates were determined at initial referral to a multidisciplinary bariatric surgery clinic and at the time of surgery. Rates of guideline concordance at both time points were compared using McNemar's test. Univariate and multivariate analyses were performed to identify the risk factors for nonconcordance.
Results: Concordance with all recommended screening was low at initial referral and significantly improved by time of surgery (39.1%‒63.8%; p<0.001). Screening rates significantly improved for HIV (p<0.001), cervical cancer (p=0.03), and colon cancer (p<0.001). Increases in BMI (p=0.005) and the number of indicated screening tests (p=0.029) were associated with reduced odds of concordance at initial referral. Smoking history (p=0.012) and increasing distance to the nearest Veterans Affairs Medical Center (p=0.039) were associated with reduced odds of change from nonconcordance at initial referral to concordance at the time of surgery.
Conclusions: Rates of preventive health screening in Veterans with obesity are low. A multidisciplinary bariatric surgery clinic is an opportunity to improve preventive health screening in Veterans referred for bariatric surgery.
(Copyright © 2022 American Journal of Preventive Medicine. All rights reserved.)
Databáze: MEDLINE
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