Cirurgias bariátricas realizadas pelo Sistema Único de Saúde no período 2010-2016: estudo descritivo das hospitalizações no Brasil*

Carvalho, Adriane da Silva; Rosa, Roger dos Santos

doi:10.5123/s1679-49742019000100023

Cited by 14 publications

(16 citation statements)

References 16 publications

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“…The multivariate analysis applied in the present study identified three clusters, named "Young, " "Diabetic individuals, " and "Poor periodontal health, " with unique characteristics and special needs that should be recognized to better assist this condition. A higher number of females composed this convenience sample, probably because de frequency of obesity is higher in females and about 80% of patients who undergo gastroplasty surgery in Brazil are women (24). Cluster 1 labeled "Young" included younger participants with higher BMI, who reported to use distractors while eating, have a lower number of meals per day and consumed sweetened drinks and processed food the day before examination.…”

Section: Discussionmentioning

confidence: 99%

Oral Health and Nutritional Characteristics of Adults With Morbid Obesity: A Multivariate Analysis

et al. 2020

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The relationship between oral health and nutritional aspects are complex, especially in individuals with chronic diseases and comorbidities, such as morbid obesity. Thus, the aim of the present study was to identify oral health and nutritional-related patterns in 113 individuals, aged 19–68 years (92 females), seeking treatment for morbid obesity. Sociodemographic variables and medical records were examined, in addition to the consumption of fruit, vegetables, candies, and processed foods. Measures of body mass index, neck, waist and hip, caries experience (DMFT index), Community Periodontal Index (CPI index), and salivary physicochemical aspects were gathered. Aspects of oral health-related quality of life and symptoms of dry mouth were evaluated by means of Oral Health Impact Profile (OHIP-14) and Xerostomia Inventory-XI questionnaires. K-means cluster analysis and, subsequently, comparisons between clusters (one-way ANOVA) were performed (α = 5%). Three clusters were generated: Cluster 1 (labeled “Young”; n = 77) was characterized by younger participants with higher BMI, who reported the use of distractors while eating, the smallest number of meals/day, and who consumed sweetened drinks and processed food the day before. Cluster 2 (labeled “Diabetic individuals”; n = 12) was characterized by older participants with the highest proportion of diabetic participants (100% were diabetic; 73% insulin users), lower BMI, higher DMFT index and OHIP-14 and xerostomia scores, and who reported having consumed fruit and vegetables the day before. Finally, Cluster 3 (labeled “Poor periodontal health”; n = 24) was characterized by participants with the worse periodontal condition (higher CPI), and lower salivary flow, pH, and buffer capacity. Cluster 1 and 2 were the groups that showed higher demand for nutritional and dietetic counseling, because of the poor eating behavior and higher serum glucose levels, respectively. On the other hand, Cluster 2 and 3 showed the higher demand for oral rehabilitation and dental treatment because of the loss of teeth and worse periodontal condition, respectively, besides the need for dietetic counseling. This sample of individuals with morbid obesity showed very unique oral-health and nutritional characteristics and special needs patterns that should be identified to adjust or change unhealthy habits, thus improving the assistance of this condition.

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Section: Discussionmentioning

confidence: 99%

Oral Health and Nutritional Characteristics of Adults With Morbid Obesity: A Multivariate Analysis

et al. 2020

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“…No Brasil, o Sistema Único de Saúde (SUS) oferece a cirurgia bariátrica para pacientes obesos que já tenham tentado outras formas de emagrecimento não cirúrgicas, porém, desprovidas de sucesso (Brasil, 2019). Além disso, a partir de 2017, a cirurgia passou a ser oferecida por videolaparoscopia, a qual é uma forma menos invasiva de realizar o procedimento e representa uma ganho para a saúde pública (Brasil, 2017;Carvalho & Rosa, 2019).…”

Section: Introductionunclassified

Anemias e deficiências nutricionais em pacientes submetidos à gastrectomia: uma revisão integrativa

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Souza

Antunes

et al. 2020

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O aumento dos índices de obesidade e a ineficácia do tratamento clínico fazem com que a busca por tratamentos cirúrgicos deva ser considerada. Ademais, tanto anemias quanto deficiências nutricionais são consequências comuns da cirurgia bariátrica. O presente estudo tem por objetivo explanar os possíveis tratamentos que buscam minimizar as alterações nutricionais e de que forma o tema vem sendo abordado em diferentes análises. A busca de artigos foi através das bases de dados PubMed e Scientific Electronic Library Online (SciELO) com a utilização dos termos “anemia and gastrectomy” e “anemia and bariatric surgery” e seus correspondentes em português. Como critérios de inclusão foram considerados: a) artigos b) estar disponível em texto completo c) estudos disponíveis nos idiomas português, inglês ou espanhol d) pesquisa clínica e) terem sido publicados entre 2015 e 2020 f) artigos que contemplem anemias carenciais e consequências clinicamente significativas da cirurgia bariátrica. Foram excluídos os textos que não tinham relação com a temática e as duplicatas. Assim, dos 22 artigos apresentados pela busca nas bases de dados, 11 foram selecionados por afinidade à temática de busca e 11 artigos foram excluídos por não serem relacionados com o assunto. A partir desse processo, percebeu-se que as anemias e as deficiências nutricionais são uma consequência comum em pacientes pós-gastrectomia. Assim, a suplementação pré-operatória e o monitoramento nutricional pós-cirúrgico são intervenções para evitar as carências nutricionais. Importante destacar o acompanhamento de pacientes gastrectomizados por equipe multiprofissional para garantir uma melhor qualidade de vida ao paciente.

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“…27,37 In Brazil, bariatric surgery was included in the list of procedures for treatment of moderate to severe obesity and made accessible to the general population within the Brazilian Unified Health System (Sistema Unico de Saude, SUS) in 1999. 38,39 There has been increasing trends in adoption of bariatric surgery throughout the public facilities, especially among young females 38 , and results of previous studies have shown low mortality risk and high effectiveness of the surgery in the country. 24,38,[40][41][42][43][44] To date, most studies focusing on assessment of costs and effectiveness of bariatric surgery in Brazil and other countries have been based on limited sample size and/or single health outcome 5,6,23,38 , or relied on modelling of future outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…38,39 There has been increasing trends in adoption of bariatric surgery throughout the public facilities, especially among young females 38 , and results of previous studies have shown low mortality risk and high effectiveness of the surgery in the country. 24,38,[40][41][42][43][44] To date, most studies focusing on assessment of costs and effectiveness of bariatric surgery in Brazil and other countries have been based on limited sample size and/or single health outcome 5,6,23,38 , or relied on modelling of future outcomes. There is limited evidence including multiple anthropometric, hemodynamic and biochemical parameters of patients 20,22,45 , especially using longitudinal data before and after bariatric surgery 27,46 .…”

Section: Introductionmentioning

confidence: 99%

“…In Brazil, bariatric surgery was included in the list of procedures for treatment of moderate to severe obesity and made accessible to the general population within the Brazilian Unified Health System (Sistema Unico de Saude, SUS) in 1999. 38,39 There has been increasing trends in adoption of bariatric surgery throughout the public facilities, especially among young females 38 , and results of previous studies have shown low mortality risk and high effectiveness of the surgery in the country.24,38,40–44…”

Section: Introductionmentioning

confidence: 99%

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Impacts of bariatric surgery on costs and health outcomes of patients in Brazil: Interrupted time series analysis of multi-panel data

Jao

et al. 2020

Preprint

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Obesity is one of the most important public health problems worldwide, presenting significant socioeconomic impacts in health systems. Considering the rising costs of health care and the escalating burden of obesity in diverse countries, there has been increasing trends in examination of cost-effectiveness of health interventions towards prevention and treatment of obesity and its effects on comorbidities. Bariatric surgery has been considered an effective intervention for reducing moderate to severe obesity and improvement of obesity-related morbidities. Methodology: Interrupted Time-Series Analysis (ITSA) on costs and health outcomes from retrospective cohort of 114 patients who had bariatric surgery at the Hospital of Clinics from the University of Sao Paulo. Medical records encompassing complete data on anthropometric, hemodynamic and biochemical parameters, utilization of resources and costs for health care procedures and regular assessments of patients health status associated with bariatric surgery at individual level were included in the study. Data on utilization of resources during outpatient and inpatient health care were used for estimation of patients direct costs referring to bariatric surgery, and 6-month pre- and post-intervention periods, adopting health system perspective in micro-costing approach. Results: Mean direct costs of hospitalization (-US$2,762.22; -23.2%), image exams (-US$7.53; -0.8%) and medication (-US$175.37; -25,7%) presented decrease after bariatric surgery, and total direct cost (US$1,375.37; +138%), consultations (US$0.42; +2.4%) and laboratory exams (US$68.96; +63.4%) had increase. Reduction in weight, BMI, LDL, triglycerides, insulin, glucose-linked hemoglobin, and glucose showed improvements in patients health status after bariatric surgery. Cholesterol, VLDL, and HDL presenting increase after surgery. Conclusion: Bariatric surgery represents an effective intervention for treatment of moderate to severe obesity with extensive benefits regarding health promotion and reduction of burden of disease. Trends in direct costs and multiple health outcomes showed post-intervention improvements in patients health status and reduction of health care needs of individuals.

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Cirurgias bariátricas realizadas pelo Sistema Único de Saúde no período 2010-2016: estudo descritivo das hospitalizações no Brasil*

Cited by 14 publications

References 16 publications

Oral Health and Nutritional Characteristics of Adults With Morbid Obesity: A Multivariate Analysis

Oral Health and Nutritional Characteristics of Adults With Morbid Obesity: A Multivariate Analysis

Anemias e deficiências nutricionais em pacientes submetidos à gastrectomia: uma revisão integrativa

Impacts of bariatric surgery on costs and health outcomes of patients in Brazil: Interrupted time series analysis of multi-panel data

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