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ABSTRACT: Background
Bariatric surgery has been used for treatment of severe obesity in adolescents but most studies have been small and limited in follow-up.Objectives
We hypothesized that electronic health record data could be used to compare effectiveness of bariatric procedures in adolescents.Setting
Data were obtained from clinical research networks using a common data model to extract data from each site.Methods
Adolescents who underwent a primary bariatric procedure from 2005 through 2015 were identified. The percent change in body mass index (BMI) at 1, 3, and 5 years was estimated using random effects linear regression for patients undergoing all operations. Propensity score adjusted estimates and 95% confidence intervals were estimated for procedures with >25 patients at each time period.Results
This cohort of 544 adolescents was predominantly female (79%) and White (66%), with mean (±standard deviation) age of 17.3 (±1.6) years and mean BMI of 49.8 (± 7.8) kg/m2. Procedures included Roux-en-Y gastric bypass (RYGB; n = 177), sleeve gastrectomy (SG; n = 306), and laparoscopic adjustable gastric banding (n = 61). For those undergoing RYGB, SG, and laparoscopic adjustable gastric banding, mean (95% confidence interval) BMI changes of -31% (-30% to -33%), -28% (-27% to -29%), and -10% (-8% to -12%), were estimated at 1 year. For RYGB and SG, BMI changes of -29% (-26% to -33%) and -25% (-22% to -28%) were estimated at 3 years.Conclusions
Adolescents undergoing SG and RYGB experienced greater declines in BMI at 1- and 3-year follow-up time points, while laparoscopic adjustable gastric banding was significantly less effective for BMI reduction.
SUBMITTER: Inge TH
PROVIDER: S-EPMC6165694 | biostudies-literature | 2018 Sep
REPOSITORIES: biostudies-literature
Inge Thomas H TH Coley R Yates RY Bazzano Lydia A LA Xanthakos Stavra A SA McTigue Kathleen K Arterburn David D Williams Neely N Wellman Rob R Coleman Karen J KJ Courcoulas Anita A Desai Nirav K NK Anau Jane J Pardee Roy R Toh Sengwee S Janning Cheri C Cook Andrea A Sturtevant Jessica J Horgan Casie C Zebrick Ava J AJ Michalsky Marc M
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery 20180417 9
<h4>Background</h4>Bariatric surgery has been used for treatment of severe obesity in adolescents but most studies have been small and limited in follow-up.<h4>Objectives</h4>We hypothesized that electronic health record data could be used to compare effectiveness of bariatric procedures in adolescents.<h4>Setting</h4>Data were obtained from clinical research networks using a common data model to extract data from each site.<h4>Methods</h4>Adolescents who underwent a primary bariatric procedure ...[more]