Dataset Information

Gastric bypass improves survival compared with propensity-matched controls: a cohort study with over 10-year follow-up.

ABSTRACT:

Background

The purpose of this study is to evaluate the long-term survival following gastric bypass using propensity-matched controls.

Methods

We identified all patients who either received a gastric bypass (GBP) or met criteria to receive a GBP between January 1, 2002 and December 31, 2003. Propensity matching was performed. Long-term, all-cause mortality data were collected and evaluated using Kaplan-Meier curves.

Results

Four hundred thirty GBP cases and 5,323 controls were identified from the enrollment period. Ultimately, 802 cases and controls (1:1 matching, 93.2% match rate) were identified using propensity matching. Median follow-up was similar between groups. Overall mortality was lower for the GBP group (odds ratio .48, 95% confidence interval .29 to .78). GBP demonstrated significantly increased survival when compared with controls (P = .002). Similar patterns were noted among diabetics.

Conclusion

We have demonstrated that gastric bypass provides a clear long-term survival advantage compared with nonsurgical propensity-matched controls.

SUBMITTER: Guidry CA

PROVIDER: S-EPMC4465556 | biostudies-literature | 2015 Mar

REPOSITORIES: biostudies-literature

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Publications

Gastric bypass improves survival compared with propensity-matched controls: a cohort study with over 10-year follow-up.

Guidry Christopher A CA Davies Stephen W SW Sawyer Robert G RG Schirmer Bruce D BD Hallowell Peter T PT

American journal of surgery 20141223 3

<h4>Background</h4>The purpose of this study is to evaluate the long-term survival following gastric bypass using propensity-matched controls.<h4>Methods</h4>We identified all patients who either received a gastric bypass (GBP) or met criteria to receive a GBP between January 1, 2002 and December 31, 2003. Propensity matching was performed. Long-term, all-cause mortality data were collected and evaluated using Kaplan-Meier curves.<h4>Results</h4>Four hundred thirty GBP cases and 5,323 controls w ...[more]

PMID: 25601559

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Project description:BackgroundThere is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts.Materials and methodsThis analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien-Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups.ResultsIn total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07).ConclusionsThis global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts.

Project description:BackgroundRoux-en-Y gastric bypass (RYGB) surgery is an effective treatment for obesity. However, the incidence and long-term risk of hypoglycemia after surgery in patients without diabetes remains unclear. This study aimed to investigate the prevalence of hypoglycemia following RYGB surgery in patients with obesity and without diabetes.MethodsA retrospective cohort study was conducted using the TriNetX database. The study population included 15,085 patients with obesity (BMI ≥ 30 kg/m2) who underwent RYGB surgery and 3,200,074 non-surgical controls, all without a history of diabetes or GLP-1 receptor agonist use. Propensity score matching was performed to balance baseline characteristics. The primary outcome was the incidence of hypoglycemia, defined by ICD-10-CM codes or laboratory values (glucose ≤ 70 mg/dL). Cox regression analysis was employed to calculate hazard ratios (HR) and 95% confidence intervals (CI).ResultsIn the overall study population, the risk of hypoglycemia was significantly higher in the RYGB group (18.70%, n = 2,810) compared to the control group (3.80%, n = 120,923; HR 4.3, 95% CI 4.14-4.46, p < 0.001). After propensity score matching (n = 14,916 per group), RYGB patients maintained an elevated risk (18.70%, n = 2,795) compared to matched controls (5.0%, n = 749; HR 3.7, 95% CI 3.44-4.05, p < 0.001). Time-series analysis revealed consistently higher hypoglycemia risk in the RYGB group, with hazard ratios ranging from 5.37 (95% CI 4.09-7.03) at 1 week to 3.75 (95% CI 3.45-4.06) at 10 years post-surgery (all p < 0.001). Subgroup analysis of RYGB patients who developed hypoglycemia showed a 30-day hospitalization rate of 21.3% and a mortality rate of 0.71%.ConclusionRYGB surgery is associated with a significantly increased risk of hypoglycemia in patients with obesity and without diabetes, both in the short-term and long-term follow-up. These findings underscore the importance of monitoring and managing hypoglycemia in patients undergoing RYGB surgery, even in the absence of preexisting diabetes.

Dataset Information

Gastric bypass improves survival compared with propensity-matched controls: a cohort study with over 10-year follow-up.

Background

Methods

Results

Conclusion

Publications

Gastric bypass improves survival compared with propensity-matched controls: a cohort study with over 10-year follow-up.

Similar Datasets

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