Perioperative safety in the longitudinal assessment of bariatric surgery.
David R. Flum,Steven H. Belle,Wendy C. King,Abdus S. Wahed,Paul D. Berk,William C. Chapman,Walter J. Pories,Anita P. Courcoulas,Carol A. McCloskey,James E. Mitchell,Emma J. Patterson,Alfons Pomp,Myrlene A. Staten,Susan Z. Yanovski,Richard C. Thirlby,Bruce M. Wolfe +15 more
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TLDR
The overall risk of death and other adverse outcomes after bariatric surgery was low and varied considerably according to patient characteristics, andExtreme values of body-mass index were significantly associated with an increased risk of the composite end point, whereas age, sex, race, ethnic group, and other coexisting conditions were not.Abstract:
BACKGROUND To improve decision making in the treatment of extreme obesity, the risks of bariatric surgical procedures require further characterization. METHODS We performed a prospective, multicenter, observational study of 30-day outcomes in consecutive patients undergoing bariatric surgical procedures at 10 clinical sites in the United States from 2005 through 2007. A composite end point of 30-day major adverse outcomes (including death; venous thromboembolism; percutaneous, endoscopic, or operative reintervention; and failure to be discharged from the hospital) was evaluated among patients undergoing first-time bariatric surgery. RESULTS There were 4776 patients who had a first-time bariatric procedure (mean age, 44.5 years; 21.1% men; 10.9% nonwhite; median body-mass index [the weight in kilograms divided by the square of the height in meters], 46.5). More than half had at least two coexisting conditions. A Roux-en-Y gastric bypass was performed in 3412 patients (with 87.2% of the procedures performed laparoscopically), and laparoscopic adjustable gastric banding was performed in 1198 patients; 166 patients underwent other procedures and were not included in the analysis. The 30-day rate of death among patients who underwent a Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding was 0.3%; a total of 4.3% of patients had at least one major adverse outcome. A history of deep-vein thrombosis or pulmonary embolus, a diagnosis of obstructive sleep apnea, and impaired functional status were each independently associated with an increased risk of the composite end point. Extreme values of body-mass index were significantly associated with an increased risk of the composite end point, whereas age, sex, race, ethnic group, and other coexisting conditions were not. CONCLUSIONS The overall risk of death and other adverse outcomes after bariatric surgery was low and varied considerably according to patient characteristics. In helping patients make appropriate choices, short-term safety should be considered in conjunction with both the long-term effects of bariatric surgery and the risks associated with being extremely obese. (ClinicalTrials.gov number, NCT00433810.)read more
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2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society
Michael D. Jensen,Donna H. Ryan,Caroline M. Apovian,Jamy D. Ard,Anthony G. Comuzzie,Karen A. Donato,Frank B. Hu,Van S. Hubbard,John M. Jakicic,Robert F. Kushner,Catherine M. Loria,Barbara E. Millen,Cathy Nonas,F. Xavier Pi-Sunyer,June Stevens,Victor J. Stevens,Thomas A. Wadden,Bruce M. Wolfe,Susan Z. Yanovski +18 more
TL;DR: This research presents a state-of-the-art online learning system that automates the very labor-intensive and therefore time-heavy and expensive and expensive process of manually cataloging and cataloging students' academic records.
2013 AHA/ACC/TOS Guideline for the Management of Overweight
Michael D. Jensen,H. Ryan,M. Apovian,Catherine M. Loria,Jamy D. Ard,Barbara E. Millen,Anthony G. Comuzzie,Cathy Nonas,Karen A. Donato,F. Xavier Pi-Sunyer,Frank B. Hu,S. Hubbard,Victor J. Stevens,John M. Jakicic,Thomas A. Wadden,Robert F. Kushner,Bruce M. Wolfe,Susan Z. Yanovski +17 more
Journal ArticleDOI
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Michael D. Jensen,Donna H. Ryan,Caroline M. Apovian,Jamy D. Ard,Anthony G. Comuzzie,Karen A. Donato,Frank B. Hu,Van S. Hubbard,John M. Jakicic,Robert F. Kushner,Catherine M. Loria,Barbara E. Millen,Cathy Nonas,F. Xavier Pi-Sunyer,June Stevens,Victor J. Stevens,Thomas A. Wadden,Bruce M. Wolfe,Susan Z. Yanovski +18 more
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Prevention of VTE in Nonorthopedic Surgical Patients : Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
Michael K. Gould,David A. Garcia,Sherry M. Wren,Paul J. Karanicolas,Juan I. Arcelus,John A. Heit,Charles M. Samama +6 more
TL;DR: In this article, the authors developed recommendations for thromboprophylaxis in nonorthopedic surgical patients by using systematic methods as described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines.
Journal ArticleDOI
Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient—2013 Update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery
Jeffrey I. Mechanick,Adrienne Youdim,Daniel B. Jones,W. Timothy Garvey,Daniel L. Hurley,M. Molly McMahon,Leslie J. Heinberg,Robert F. Kushner,Ted D. Adams,Scott A. Shikora,John Dixon,Stacy A. Brethauer +11 more
TL;DR: These updated guidelines reflect recent additions to the evidence base and include Examples of expanded topics in this update include: the roles of sleeve gastrectomy, bariatric surgery in patients with type‐2 diabetes,bariatric surgery for patients with mild obesity, copper deficiency, informed consent, and behavioral issues.
References
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Journal ArticleDOI
Bariatric surgery: a systematic review and meta-analysis.
Henry Buchwald,Yoav Avidor,Eugene Braunwald,Michael D. Jensen,Walter J. Pories,Kyle Fahrbach,Karen Schoelles +6 more
TL;DR: Effective weight loss was achieved in morbidly obese patients after undergoing bariatric surgery, and a substantial majority of patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete resolution or improvement.
Journal ArticleDOI
Effects of bariatric surgery on mortality in Swedish obese subjects.
Lars Sjöström,Kristina Narbro,C. David Sjöström,Kristjan Karason,B Larsson,Hans Wedel,Theodore Lystig,Marianne Sullivan,Claude Bouchard,Björn Carlsson,Calle Bengtsson,Sven Dahlgren,Anders Gummesson,Peter Jacobson,Jan Karlsson,Anna Karin Lindroos,Hans Lönroth,Ingmar Näslund,Torsten Olbers,Kaj Stenlöf,Jarl S Torgerson,Göran Ågren,Lena M. S. Carlsson +22 more
TL;DR: Bariatric surgery for severe obesity is associated with long-term weight loss and decreased overall mortality.
Journal ArticleDOI
Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery
TL;DR: A prospective, controlled Swedish Obese Subjects Study involved obese subjects who underwent gastric surgery and contemporaneously matched, conventionally treated obese control subjects, which reported follow-up data for subjects who had been enrolled for at least 2 years or 10 years before the analysis.
Journal ArticleDOI
Long-Term Mortality after Gastric Bypass Surgery
Ted D. Adams,Richard E. Gress,Sherman C. Smith,R. Chad Halverson,Steven C. Simper,Wayne D. Rosamond,Michael J. LaMonte,Antoinette M. Stroup,Steven C. Hunt +8 more
TL;DR: Long-term total mortality after gastric bypass surgery was significantly reduced, particularly deaths from diabetes, heart disease, and cancer, however, the rate of death from causes other than disease was higher in the surgery group than in the control group.
Journal ArticleDOI
Bariatric surgery. A systematic review and meta-analysis
TL;DR: Effective weight loss was achieved in morbidly obese patients after undergoing bariatric surgery, and a substantial majority of patients with diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete resolution or improvement.
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