Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica

Detalhes bibliográficos
Autor(a) principal: Almeida, Rebeca Rocha de
Data de Publicação: 2018
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UFS
Texto Completo: http://ri.ufs.br/jspui/handle/riufs/7478
Resumo: INTRODUCTION: Obesity is associated with an increased cardiovascular risk factor in all social classes and bariatric surgery (BS) has been widely used to promote weight loss and, consequently, reduce cardiometabolic risk (CR). However, there is a shortage of studies showing the disparity in clinical and nutritional evolution after BS, in users of the Unified Health System (UHS) and the Supplementary Health Network (SHN). OBJECTIVE: To evaluate the behavior of the factors associated to the CR of the patients submitted to BS under UHS and SHN. METHODS: This is an observational longitudinal analytical study performed in patients of both sexes submitted to BS under UHS and SHN. The anthropometric and clinical parameters related to the CR (Diabetes Melittus (DM), dyslipidemia and Systemic Hypertension (SAH)) were evaluated, and quantified using the Obesity-Related Comorbidity Assessment (ACRO) score at the following time points: admission, preoperative and in the postoperative returns (3, 6 and 12 months). Statistical analyzes were performed using the Statistical Package for the Social Science, SPSS®, version 17.0 for Windows, considering at the 5%(p <0.05) level of significance. RESULTS: The mean age of the sample was 39.6 ± 10.8 years, the majority being female (72.1%). At the time of admission to BS, UHS users, compared to SHN, had higher frequencies of severe obesity (p <0.0001), SAH (p = 0.008) and DM (p = 0.018). The time elapsed between initial and pre-surgical evaluation was higher for UHS patients (p <0.0001); and, in this period, there was a reduction of the AORC, at the expense of SAH, only in the SHN group. However, it was observed that the two groups showed a reduction of comorbidities in the postoperative period in such a way that there was no difference between the two in the AORC score of 3, 6 and 12 months of BS. CONCLUSION: In the scope of UHS, BS is performed in patients with a higher degree of comorbidities but, the BS provided a reduction of the CR similar to that observed in SHN.
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spelling Almeida, Rebeca Rocha deSousa, Antônio Carlos SobralSouza, Márcia Ferreira Cândido de2018-03-06T17:35:34Z2018-03-06T17:35:34Z2018-02-09ALMEIDA, Rebeca Rocha de. Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica. 2018. 83 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Sergipe, Aracaju, SE, 2018.http://ri.ufs.br/jspui/handle/riufs/7478INTRODUCTION: Obesity is associated with an increased cardiovascular risk factor in all social classes and bariatric surgery (BS) has been widely used to promote weight loss and, consequently, reduce cardiometabolic risk (CR). However, there is a shortage of studies showing the disparity in clinical and nutritional evolution after BS, in users of the Unified Health System (UHS) and the Supplementary Health Network (SHN). OBJECTIVE: To evaluate the behavior of the factors associated to the CR of the patients submitted to BS under UHS and SHN. METHODS: This is an observational longitudinal analytical study performed in patients of both sexes submitted to BS under UHS and SHN. The anthropometric and clinical parameters related to the CR (Diabetes Melittus (DM), dyslipidemia and Systemic Hypertension (SAH)) were evaluated, and quantified using the Obesity-Related Comorbidity Assessment (ACRO) score at the following time points: admission, preoperative and in the postoperative returns (3, 6 and 12 months). Statistical analyzes were performed using the Statistical Package for the Social Science, SPSS®, version 17.0 for Windows, considering at the 5%(p <0.05) level of significance. RESULTS: The mean age of the sample was 39.6 ± 10.8 years, the majority being female (72.1%). At the time of admission to BS, UHS users, compared to SHN, had higher frequencies of severe obesity (p <0.0001), SAH (p = 0.008) and DM (p = 0.018). The time elapsed between initial and pre-surgical evaluation was higher for UHS patients (p <0.0001); and, in this period, there was a reduction of the AORC, at the expense of SAH, only in the SHN group. However, it was observed that the two groups showed a reduction of comorbidities in the postoperative period in such a way that there was no difference between the two in the AORC score of 3, 6 and 12 months of BS. CONCLUSION: In the scope of UHS, BS is performed in patients with a higher degree of comorbidities but, the BS provided a reduction of the CR similar to that observed in SHN.INTRODUÇÃO: A obesidade está associada com crescente fator de risco cardiovascular em todas as classes sociais e a cirurgia bariátrica (CB) tem sido muito utilizada para promover perda de peso e, consequentemente, reduzir o risco cardiometabólico (RCM).Todavia, existe escassez de estudos mostrando a disparidade na evolução clínica e nutricional após CB, em usuários do Sistema Único de Saúde (SUS) e da Rede suplementar de Saúde (RS). OBJETIVO: Avaliar a redução dos fatores associados ao RCM dos pacientes submetidos à CB no âmbito do SUS e RS. MÉTODOS: Trata-se de um estudo de caráter observacional, longitudinal, analítico, realizado com pacientes de ambos os sexo, submetidos a CB no âmbito do SUS e da RS. Foram avaliados os parâmetros antropométricos e clínicos relacionados ao RCM (Diabetes Melittus (DM), dislipidemia e Hipertensão Arterial Sistêmica (HAS)), e quantificado mediante o escore Avaliação das Comorbidades Relacionadas à Obesidade (ACRO), nos seguintes momentos: admissão, pré-operatório e nos retornos do pós-operatório (3, 6 e 12 meses). As análises estatísticas foram realizadas utilizando o Statistical Package for the Social Science, SPSS®, versão 17.0 para Windows, considerando nível de significância de 5% (p < 0,05). RESULTADOS: A média de idade da amostra foi de 39,6 ± 10,8 anos, sendo a maioria do sexo feminino (72,1 %). No momento da admissão para CB, os usuários dos SUS, comparativamente aos da RS, tiveram maiores frequências de obesidade grave (p<0,0001), HAS (p=0,008) e DM (p=0,018). O tempo decorrido entre avaliação inicial e o pré-cirúrgico foi maior para os pacientes do SUS (p<0,0001); e nesse período verificou redução do ACRO, as custas da HAS, somente no grupo da RS. Todavia constatou-se que os dois grupos apresentaram redução das comorbidades no pós-operatório de tal forma que não se observou diferença entre ambos no escore ACRO de 3, 6 e 12 meses de CB. CONCLUSÃO: No âmbito do SUS é realizado a CB em pacientes com maior grau de comorbidades, porém a CB propiciou redução do RCM semelhante ao verificado na RS.Aracaju, SEporObesidadeCirurgia bariátricaDiabetesHipertensãoDiabetes mellitusDislipidemiaBariatric surgeryHypertensionDyslipidemiaCIENCIAS DA SAUDERedução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátricaReduction of cardiometabolic risk in users of the Unified Health System and the Supplemental Health Network submitted to bariatric surgeryinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisPós-Graduação em Ciências da SaúdeUniversidade Federal de Sergipereponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/7478/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALREBECA_ROCHA_ALMEIDA.pdfREBECA_ROCHA_ALMEIDA.pdfapplication/pdf1267420https://ri.ufs.br/jspui/bitstream/riufs/7478/2/REBECA_ROCHA_ALMEIDA.pdff2715a9b67980a233b44b627948f9022MD52TEXTREBECA_ROCHA_ALMEIDA.pdf.txtREBECA_ROCHA_ALMEIDA.pdf.txtExtracted texttext/plain143579https://ri.ufs.br/jspui/bitstream/riufs/7478/3/REBECA_ROCHA_ALMEIDA.pdf.txtaae541bba5b45baffad67c7f7fc59740MD53THUMBNAILREBECA_ROCHA_ALMEIDA.pdf.jpgREBECA_ROCHA_ALMEIDA.pdf.jpgGenerated Thumbnailimage/jpeg1208https://ri.ufs.br/jspui/bitstream/riufs/7478/4/REBECA_ROCHA_ALMEIDA.pdf.jpge9cbddce82989d2be2b1f281b7b53c63MD54riufs/74782018-03-06 14:35:34.762oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2018-03-06T17:35:34Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false
dc.title.pt_BR.fl_str_mv Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica
dc.title.alternative.eng.fl_str_mv Reduction of cardiometabolic risk in users of the Unified Health System and the Supplemental Health Network submitted to bariatric surgery
title Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica
spellingShingle Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica
Almeida, Rebeca Rocha de
Obesidade
Cirurgia bariátrica
Diabetes
Hipertensão
Diabetes mellitus
Dislipidemia
Bariatric surgery
Hypertension
Dyslipidemia
CIENCIAS DA SAUDE
title_short Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica
title_full Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica
title_fullStr Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica
title_full_unstemmed Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica
title_sort Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica
author Almeida, Rebeca Rocha de
author_facet Almeida, Rebeca Rocha de
author_role author
dc.contributor.author.fl_str_mv Almeida, Rebeca Rocha de
dc.contributor.advisor1.fl_str_mv Sousa, Antônio Carlos Sobral
dc.contributor.advisor-co1.fl_str_mv Souza, Márcia Ferreira Cândido de
contributor_str_mv Sousa, Antônio Carlos Sobral
Souza, Márcia Ferreira Cândido de
dc.subject.por.fl_str_mv Obesidade
Cirurgia bariátrica
Diabetes
Hipertensão
Diabetes mellitus
Dislipidemia
topic Obesidade
Cirurgia bariátrica
Diabetes
Hipertensão
Diabetes mellitus
Dislipidemia
Bariatric surgery
Hypertension
Dyslipidemia
CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv Bariatric surgery
Hypertension
Dyslipidemia
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE
description INTRODUCTION: Obesity is associated with an increased cardiovascular risk factor in all social classes and bariatric surgery (BS) has been widely used to promote weight loss and, consequently, reduce cardiometabolic risk (CR). However, there is a shortage of studies showing the disparity in clinical and nutritional evolution after BS, in users of the Unified Health System (UHS) and the Supplementary Health Network (SHN). OBJECTIVE: To evaluate the behavior of the factors associated to the CR of the patients submitted to BS under UHS and SHN. METHODS: This is an observational longitudinal analytical study performed in patients of both sexes submitted to BS under UHS and SHN. The anthropometric and clinical parameters related to the CR (Diabetes Melittus (DM), dyslipidemia and Systemic Hypertension (SAH)) were evaluated, and quantified using the Obesity-Related Comorbidity Assessment (ACRO) score at the following time points: admission, preoperative and in the postoperative returns (3, 6 and 12 months). Statistical analyzes were performed using the Statistical Package for the Social Science, SPSS®, version 17.0 for Windows, considering at the 5%(p <0.05) level of significance. RESULTS: The mean age of the sample was 39.6 ± 10.8 years, the majority being female (72.1%). At the time of admission to BS, UHS users, compared to SHN, had higher frequencies of severe obesity (p <0.0001), SAH (p = 0.008) and DM (p = 0.018). The time elapsed between initial and pre-surgical evaluation was higher for UHS patients (p <0.0001); and, in this period, there was a reduction of the AORC, at the expense of SAH, only in the SHN group. However, it was observed that the two groups showed a reduction of comorbidities in the postoperative period in such a way that there was no difference between the two in the AORC score of 3, 6 and 12 months of BS. CONCLUSION: In the scope of UHS, BS is performed in patients with a higher degree of comorbidities but, the BS provided a reduction of the CR similar to that observed in SHN.
publishDate 2018
dc.date.accessioned.fl_str_mv 2018-03-06T17:35:34Z
dc.date.available.fl_str_mv 2018-03-06T17:35:34Z
dc.date.issued.fl_str_mv 2018-02-09
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.citation.fl_str_mv ALMEIDA, Rebeca Rocha de. Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica. 2018. 83 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Sergipe, Aracaju, SE, 2018.
dc.identifier.uri.fl_str_mv http://ri.ufs.br/jspui/handle/riufs/7478
identifier_str_mv ALMEIDA, Rebeca Rocha de. Redução do risco cardiometabólico em usuários do Sistema Único de Saúde e da Rede Suplementar submetidos à cirurgia bariátrica. 2018. 83 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Sergipe, Aracaju, SE, 2018.
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