TY - JOUR
T1 - Bariatric Surgery Among Medicare Subgroups
T2 - Short- and Long-Term Outcomes
AU - Walker, Elizaveta
AU - Elman, Miriam
AU - Takemoto, Erin E.
AU - Fennern, Erin
AU - Mitchell, James E.
AU - Pories, Walter J.
AU - Ahmed, Bestoun
AU - Pomp, Alfons
AU - Wolfe, Bruce M.
N1 - Funding Information:
agencies: The Longitudinal Assessment of Bariatric Surgery (LABS-2) was funded by a cooperative agreement by the NIDDK: grant U01 DK066557 (Data Coordinating Center), grant U01-DK66667 (Columbia University) (in collaboration with Cornell University Medical Center Clinical Translational Research Center grant UL1-RR024996), grant U01-DK66568 (University of Washington) (in collaboration with Clinical Translational Research Center grant M01RR-00037), grant U01-DK66471 (Neuropsychiatric Research Institute), grant U01-DK66526 (East Carolina University), grant U01-DK66585 (University of Pittsburgh Medical Center) (in collaboration with Clinical Translational Research Center grant UL1-RR024153), and grant U01-DK66555 (Oregon Health and Science University).The authors wish to sincerely thank Dr. Carrie M. Nielson for her time, guidance, and expertise. Dr. Nielson’s mentorship was invaluable for the completion of this article. This article is based on a subset of the LABS-2 observational cohort. The complete cohort has been described. An abstract of this study was presented at Obesity Week 2018 in Nashville, Tennessee, on November 13, 2018. Individual deidentified participant data (including data dictionaries) can be made immediately available to external investigators (upon request to the senior author) once the research team has completed planned analyses. This is expected to be approximately 1 year after publication of this study. Other documents (e.g., study protocol, informed consent form, clinical assessment forms) can be accessed at http://www.edc.gsph.pitt.edu/labs/Public/LABS-1DescriptionPaper/.
Publisher Copyright:
© 2019 The Obesity Society
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objective: This study sought to examine weight change, postoperative adverse events, and related outcomes of interest among age-qualified (AQ) and disability-qualified (DQ) Medicare recipients compared with non-Medicare (NM) patients undergoing an initial bariatric procedure. Methods: The Longitudinal Assessment of Bariatric Surgery (LABS-2) is an observational cohort study of 2,458 adults who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB) bariatric surgery. Weight, percentage body fat, functional status, and comorbidities, as well as postoperative adverse events, were assessed at baseline and annually for 5 years. The 1,943 participants who reported insurance type were categorized into the following groups: AQ, DQ, or NM. Results: The median preoperative BMI ranged from 45 to 48 kg/m2 across groups. For RYGB, 5-year BMI loss was approximately 30% for all groups, and for LAGB, BMI loss was 12% to 15%. Diabetes remission after 5 years was also similar across groups within procedure types (RYGB: 33%-40%; LAGB: 13%-19%). The frequency of adverse events after RYGB ranged from 4.1% for NM participants to 6.7% for DQ participants. After LAGB, there were no adverse events for the AQ group, whereas 3% of DQ participants and 1.8% of NM participants had at least one adverse event. Conclusions: Medicare participants experienced substantial BMI loss and diabetes remission, with a frequency of adverse events similar to that of NM participants.
AB - Objective: This study sought to examine weight change, postoperative adverse events, and related outcomes of interest among age-qualified (AQ) and disability-qualified (DQ) Medicare recipients compared with non-Medicare (NM) patients undergoing an initial bariatric procedure. Methods: The Longitudinal Assessment of Bariatric Surgery (LABS-2) is an observational cohort study of 2,458 adults who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB) bariatric surgery. Weight, percentage body fat, functional status, and comorbidities, as well as postoperative adverse events, were assessed at baseline and annually for 5 years. The 1,943 participants who reported insurance type were categorized into the following groups: AQ, DQ, or NM. Results: The median preoperative BMI ranged from 45 to 48 kg/m2 across groups. For RYGB, 5-year BMI loss was approximately 30% for all groups, and for LAGB, BMI loss was 12% to 15%. Diabetes remission after 5 years was also similar across groups within procedure types (RYGB: 33%-40%; LAGB: 13%-19%). The frequency of adverse events after RYGB ranged from 4.1% for NM participants to 6.7% for DQ participants. After LAGB, there were no adverse events for the AQ group, whereas 3% of DQ participants and 1.8% of NM participants had at least one adverse event. Conclusions: Medicare participants experienced substantial BMI loss and diabetes remission, with a frequency of adverse events similar to that of NM participants.
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U2 - 10.1002/oby.22613
DO - 10.1002/oby.22613
M3 - Article
C2 - 31562705
AN - SCOPUS:85073981707
VL - 27
SP - 1820
EP - 1827
JO - Obesity
JF - Obesity
SN - 1930-7381
IS - 11
ER -