Frequência de colecistectomia e fatores de risco sociodemográficos e clínicos associados no estudo ELSA-Brasil

Autores

  • Kamila Rafaela Alves Universidade de São Paulo
  • Alessandra Carvalho Goulart Universidade de São Paulo
  • Roberto Marini Ladeira Universidade de São Paulo
  • Ilka Regina Souza de Oliveira Universidade de São Paulo
  • Isabela Martins Benseñor Universidade de São Paulo

Palavras-chave:

Colecistectomia, Fatores de risco, Obesidade, Características da população, Brasil

Resumo

CONTEXTO E OBJETIVO: Há escassez de dados na literatura sobre a frequência de colecistectomia no Brasil. Avaliou-se a frequência de colecistectomia e os fatores de risco associados no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). DESENHO E LOCAL: Estudo transversal com dados da linha de base de 5061 participantes em São Paulo. MÉTODOS: Avaliou-se a frequência de colecistectomia e fatores de risco associados nos dois primeiros anos de seguimento do estudo e ao longo da vida. Apresentou-se regressão logística [razão de chances (RC); intervalo de confiança de 95% (IC 95%)] multivariada. RESULTADOS: Um total de 4716 (93,2%) indivíduos com informação sobre colecistectomia foi incluído. Após 2 anos de seguimento, 56 participantes tinham sido operados (1,2%: 1,7% nas mulheres; 0,6% nos homens), totalizando 188 participantes com colecistectomia durante a vida. Os fatores de risco associados à cirurgia após dois dois anos de seguimento foram sexo feminino (RC, 2,85; IC 95%, 1,53-5,32), etnia indígena (RC, 2,1; IC 95%, 2,28-15,85) e índice de massa corpórea, IMC (RC, 1,10; IC 95%, 1,01-1,19 por aumento de 1 kg/m2 ); e, ao longo da vida: idade (RC, 1,03; IC 95%, 1,02-1,05 por um ano de aumento), diabetes (RC, 2,10; IC 95%, 1,34-2,76) e cirurgia bariátrica prévia (RC, 5.37; IC 95%, 1,53-18,82). Não se observou associação com paridade ou idade fértil. CONCLUSÃO: Sexo feminino e IMC elevado permanecem sendo fatores de risco associados à colecistectomia, mas paridade e idade fértil perderam significância. Novos fatores de risco, como cirurgia bariátrica prévia e etnia indígena, ganharam relevância no país.

Downloads

Não há dados estatísticos.

Biografia do Autor

Kamila Rafaela Alves, Universidade de São Paulo

BSc. Postgraduate Student, Department of Medicine, Education and Health, Universidade de São Paulo (USP), São Paulo, SP, Brazil.

Alessandra Carvalho Goulart, Universidade de São Paulo

MD, PhD. Clinical Epidemiologist and Researcher, Center for Clinical and Epidemiological Research, University Hospital, Universidade de São Paulo (USP), São Paulo, SP, Brazil.

Roberto Marini Ladeira, Universidade de São Paulo

MD, PhD. Attending Physician at Hospital Foundation of the State of Minas Gerais, Epidemiologist in the Municipal Health Department of Belo Horizonte, MG, Brazil and Director of the Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil), Belo Horizonte, MG, Brazil.

Ilka Regina Souza de Oliveira, Universidade de São Paulo

MD, PhD. Professor, Department of Radiology, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil.

Isabela Martins Benseñor, Universidade de São Paulo

MD, PhD. Professor, Department of Internal Medicine, and Director of Center for Clinical and Epidemiological Research, University Hospital, Universidade de São Paulo (USP), São Paulo, SP, Brazil.

Referências

Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep. 2005;7(2):132-40.

Shaffer EA. Gallstone disease: Epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol. 2006;20(6):981-96.

Aerts R, Penninckx F. The burden of gallstone disease in Europe. Aliment Pharmacol Ther. 2003;18 Suppl:49-53.

Coelho JC, Bonilha R, Pitaki SA, et al. Prevalence of gallstones in Brazilian population. Int Surg. 1999;84(1):25-8.

Kang JY, Ellis C, Majeed A, et al. Gallstones--an increasing problem: a study of hospital admissions in England between 1989/1990 and 1999/2000. Aliment Pharmacol Ther. 2003;17(4):561-9.

Nenner RP, Imperato PJ, Rosenberg C, Ronberg E. Increased cholecystectomy rates among Medicare patients after the introduction of laparoscopic cholecystectomy. J Community Health. 1994;19(6):409-15.

Maringhini A, Ciambra M, Baccelliere P, et al. Biliary sludge and gallstones in pregnancy: incidence, risk factors, and natural history. Ann Intern Med. 1993;119(2):116-20.

Maclure KM, Hayes KC, Colditz GA, et al. Weight, diet, and the risk of symptomatic gallstones in middle-aged women. N Engl J Med. 1989;321(9):563-9.

Sandler RS, Everhart JE, Donowitz M, et al. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122(5):1500-11.

Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology. 1999;117(3):632-9.

Liu CM, Tung TH, Chou P, et al. Clinical correlation of gallstone disease in a Chinese population in Taiwan: experience at Cheng Hsin General Hospital. World J Gastroenterol. 2006;12(8):1281-6.

Aquino EML, Barreto SM, Bensenor IM, et al. Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): objectives and design. Am J Epidemiol. 2012;175(4):315-24.

Lotufo PA. [Setting up the longitudinal study for adult health (ELSA- Brasil)]. Rev Saude Publica. 2013;47 Suppl 2:3-9.

Schmidt MI, Duncan BB, Mill JG, et al. Cohort Profile: Longitudinal Study of Adult Health (ELSA-Brasil). Int J Epidemiol. 2015;44(1):68-75.

Bensenor IM, Griep RH, Pinto KA, et al. Rotinas de organização de exames e entrevistas no centro de investigação ELSA-Brasil [Routines of organization of clinical tests and interviews in the ELSA-Brasil investigation center]. Rev Saude Publica. 2013;47(suppl 2):37-47.

Goulart AC, Oliveira IR, Alencar AP, et al. Diagnostic accuracy of a noninvasive hepatic ultrasound score for non-alcoholic fatty liver disease (NAFLD) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Sao Paulo Med J. 2015;133(2):115-24.

Chor D, Alves MGM, Giatti L, et al. Questionario do ELSA-Brasil: desafios na elaboracao de instrumento multidimensional [Questionnaire development in ELSA-Brasil: challenges of a multidimensional instrument]. Rev Saude Publica. 2013;47(supl. 2):27-36.

Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign: Human Kinetics Publishers; 1988.

World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization; 1995.

Mill JG, Pinto K, Griep RH, et al. Aferições e exames clínicos realizados nos participantes do ELSA-Brasil [Medical assessments and measurements in ELSA-Brasil]. Rev Saude Publica. 2013;47(supl. 2):54-62.

Lewis G, Pelosi AJ, Araya R, Dunn G. Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med. 1992;22(2):465-86.

World Health Organization. International Statistical Classification of Diseases and Related Health Problems. 10th Revision. Geneva: World Health Organization; 2010. Available from: http://www.who.int/classifications/icd/ICD10Volume2_en_2010.pdf. Accessed in 2016 (Mar 3).

Barreto SM, Ladeira RM, Bastos MSCBO, et al. Estratégias de identificação, investigação e classificação de desfechos incidentes no ELSA-Brasil [ELSA-Brasil strategies for outcome identification, investigation and ascertainment]. Rev Saude Publica. 2013;47(supl. 2):79-86.

Völzke H, Baumeister SE, Alte D, et al. Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence. Digestion. 2005;7(2):97-105.

Barbara L, Sama C, Morselli-Labate AM, et al. A population study on the prevalence of gallstone disease: the Sirmione study. Hepatology. 1987;7(5):913-7.

Walcher T, Haenle MM, Kron M, et al. Pregnancy is not a risk factor for gallstone disease: results of a randomly selected population sample. World J Gastroenterol. 2005;11(43):6800-6.

Pedersen G, Hoem D, Andrén-Sandberg A. Influence of laparoscopic cholecystectomy on the prevalence of operations for gallstones in Norway. Eur J Surg. 2002;168(8-9):464-9.

Chen CY, Lu CL, Huang YS, et al. Age is one of the risk factors in developing gallstone disease in Taiwan. Age Aging. 1998;27(4):437-41.

The epidemiology of gallstone disease in Rome, Italy. Part I. Prevalence data in men. The Rome Group for Epidemiology and Prevention of Cholelithiasis (GREPCO). Hepatology. 1988;8(4):904-6.

Attili F, Capocaccia L, Carulli N, et al. Factors associated with gallstone disease in the MICOL experience. Multicenter Italian Study on Epidemiology of Cholelithiasis. Hepatology. 1997;26(4):809-18.

Sampliner RE, Bennett PH, Comess LJ, Rose FA, Burch TA. Gallbladder disease in pima indians. Demonstration of high prevalence and early onset by cholecystography. N Engl J Med. 1970;283(25):1358-64.

LaMont JT, Smith BF, Moore JR. Role of gallbladder mucin in pathophysiology of gallstones. Hepatology. 1984;4(5 Suppl):51S-56S.

Miquel JF, Covarrubias C, Villaroel L, et al. Genetic epidemiology of cholesterol cholelithiasis among Chilean Hispanics, Amerindians, and Maoris. Gastroenterology. 1998;115(4):937-46.

Friedman LS, Roberts MS, Brett AS, Marton KI. Management of asymptomatic gallstones in the diabetic patient. A decision analysis. Ann Intern Med. 1988;109(11):913-9.

Diehl AK, Stern MP, Ostrower VS, Friedman PC. Prevalence of clinical gallbladder disease in Mexican-American, Anglo, and black women. South Med J. 1980;73(4):438-41, 443.

Hanis CL, Hewett-Emmett D, Kubrusly LF, et al. An ultrasound survey of gallbladder disease among Mexican Americans in Starr County, Texas: frequencies and risk factors. Ethn Dis. 1993;3(1):32-43.

Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Statin use and the risk of cholecystectomy in women. Gastroenterology. 2009;136(5):1593-600.

Yang H, Petersen GM, Roth MP, Schoenfield LJ, Marks JW. Risk factors for gallstone formation during rapid loss of weight. Dig Dis Sci. 1992;37(6):912-8.

A prospective analysis of 1518 laparoscopic cholecystectomies. The Southern Surgeons Club. N Engl J Med. 1991;324(16):1073-8.

Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev. 2006;(4):CD006231.

To KB, Cherry-Bukowiec JR, Englesbe MJ, et al. Emergent versus elective cholecystectomy: conversion rates and outcomes. Surg Infect (Larchmt). 2013;14(6):512-9.

Dua A, Aziz A, Desai SS, McMaster J, Kuy SR. National Trends in the Adoption of Laparoscopic Cholecystectomy over 7 Years in the United States and Impact of Laparoscopic Approaches Stratified by Age. Minim Invasive Surg. 2014;2014:635461.

Downloads

Publicado

2016-06-02

Como Citar

1.
Alves KR, Goulart AC, Ladeira RM, Oliveira IRS de, Benseñor IM. Frequência de colecistectomia e fatores de risco sociodemográficos e clínicos associados no estudo ELSA-Brasil. Sao Paulo Med J [Internet]. 2º de junho de 2016 [citado 14º de março de 2025];134(3):240-5. Disponível em: https://periodicosapm.emnuvens.com.br/spmj/article/view/1060

Edição

Seção

Artigo Original