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Comparative effectiveness of bariatric procedures among adolescents: the PCORnet bariatric study.


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

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Comparative effectiveness of bariatric procedures among adolescents: the PCORnet bariatric study.

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]

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