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Surg Obes Relat Dis. 2018 Jul;14(7):1033-1040. doi: 10.1016/j.soard.2018.02.012. Epub 2018 Feb 15.

Obesity surgery makes patients healthier and more functional: real world results from the United Kingdom National Bariatric Surgery Registry.

Author information

1
Imperial College London, Division of Diabetes, Endocrinology and Metabolism, Hammersmith Hospital Campus, London, United Kingdom.
2
Imperial College London, Division of Diabetes, Endocrinology and Metabolism, Hammersmith Hospital Campus, London, United Kingdom. Electronic address: akamocka@nhs.net.
3
Leeds Teaching Hospitals, West Yorkshire, United Kingdom.
4
Royal Cornwall Hospital, Truro, United Kingdom.
5
Southmead Hospital, Westbury-on-Trym, Bristol, United Kingdom.
6
St. George's University Hospital, London, United Kingdom.
7
Hull and East Yorkshire Hospital, Hull, United Kingdom.
8
Sunderland Hospital, Sunderland, United Kingdom.
9
Queen Alexandra Hospital, Portsmouth, United Kingdom.
10
Imperial College London, Imperial Clinical Trials Unit, London, United Kingdom.
11
Dendrite Clinical Systems Ltd, The Hub, Henley-on-Thames, United Kingdom.
12
Imperial College London, Division of Diabetes, Endocrinology and Metabolism, Hammersmith Hospital Campus, London, United Kingdom; Diabetes Complications Research Centre, Conway Institute, University College Dublin, Belfield, Dublin, Ireland.
13
Department of Upper GI and Bariatric Surgery, Musgrove Park Hospital, Taunton, United Kingdom.

Abstract

BACKGROUND:

The National Bariatric Surgery Registry (NBSR) is the largest bespoke database in the field in the United Kingdom.

OBJECTIVES:

Our aim was to analyze the NBSR to determine whether the effects of obesity surgery on associated co-morbidities observed in small randomized controlled clinical trials could be replicated in a "real life" setting within U.K. healthcare.

SETTING:

United Kingdom.

METHODS:

All NBSR entries for operations between 2000 and 2015 with associated demographic and co-morbidity data were analyzed retrospectively.

RESULTS:

A total of 50,782 entries were analyzed. The patients were predominantly female (78%) and white European with a mean age of 45 ± 11 years and a mean body mass index of 48 ± 8 kg/m2. Over 5 years of follow-up, statistically significant reductions in the prevalence of type 2 diabetes, hypertension, dyslipidemia, sleep apnea, asthma, functional impairment, arthritis, and gastroesophageal reflux disease were observed. The "remission" of these co-morbidities was evident 1 year postoperatively and reached a plateau 2 to 5 years after surgery. Obesity surgery was particularly effective on functional impairment and diabetes, almost doubling the proportion of patients able to climb 3 flights of stairs and halving the proportion of patients with diabetes related hyperglycemia compared with preoperatively. Surgery was safe with a morbidity of 3.1% and in-hospital mortality of .07% and a reduced median inpatient stay of 2 days, despite an increasingly sick patient population.

CONCLUSIONS:

Obesity surgery in the U.K. results not only in weight loss, but also in substantial improvements in obesity-related co-morbidities. Appropriate support and funding will help improve the quality of the NBSR data set even further, thus enabling its use to inform healthcare policy.

KEYWORDS:

Bariatric surgery; Diabetes; Functional status; Metabolic surgery; Obesity; Surgical registry

PMID:
29778650
PMCID:
PMC6097875
DOI:
10.1016/j.soard.2018.02.012
[Indexed for MEDLINE]
Free PMC Article

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