National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 53 Research Studies DisplayedLiu S, Matvekas A, Naimi T
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
This study’s objective was to use algorithms that repurpose radiologic data into body composition (morphomics) to aid in informing dosing decisions for the antibiotic cefazolin for patients undergoing colorectal surgery who have obesity. This prospective study measured cefazolin plasma, fat, and colon tissue concentrations in these patients to develop a morphomics-informed population pharmacokinetic (PopPK) model to guide dose adjustments. A physiologically-based pharmacokinetic (PBPK) model was also constructed to inform tissue partitioning in 21 morbidly obese patients (body mass index ≥35 kg/m2 with one or more co-morbid conditions). Morphomics and pharmacokinetic data were available in 58 patients with a median weight of 95.9 kg and and 55 years, respectively. The plasma-to-subcutaneous fat partition coefficient was predicted to be 0.072 for the PopPK model and 0.060 for the PBPK model. Covariates of cefazolin exposure were identified as the estimated creatinine clearance (eCL(cr) ) and body depth at the third lumbar vertebra (body depth_L3). The authors concluded that kidney function and morphomics were more informative than body weight as covariates of cefazolin target site exposure. They advised that data from more diverse populations, consensus on target cefazolin exposure, and comparative studies are needed before a change in practice can be implemented.
AHRQ-funded; HS027183.
Citation: Liu S, Matvekas A, Naimi T .
Morphomics-informed population pharmacokinetic and physiologically-based pharmacokinetic modeling to optimize cefazolin surgical prophylaxis.
Pharmacotherapy 2024 Jan; 44(1):77-86. doi: 10.1002/phar.2878..
Keywords: Surgery, Antibiotics, Medication, Prevention, Obesity, Healthcare-Associated Infections (HAIs)
Lucy AT, Rakestraw SL, Stringer C
Readability of patient education materials for bariatric surgery.
This paper examined readability and reading level of online bariatric surgery and standardized perioperative electronic medical record (EMR) patient education materials (PEM). National organizations recommend that PEM not exceed a sixth grade reading level. One institution was used to assess readability of PEM. Text readability was assessed by seven validated instruments and mean readability scores calculated with standard deviations and compared using unpaired t-tests. A total of 32 webpages and seven EMR education documents were assessed. Web pages were overall assessed as "difficult to read" compared to "standard/average" readability EMR materials. All web pages were at or above high school reading levels, with the highest reading levels being pages with nutrition information and the lowest reading level patient testimonials. EMR materials were found to be at sixth to ninth grade reading level.
AHRQ-funded; HS023009.
Citation: Lucy AT, Rakestraw SL, Stringer C .
Readability of patient education materials for bariatric surgery.
Surg Endosc 2023 Aug; 37(8):6519-25. doi: 10.1007/s00464-023-10153-3..
Keywords: Surgery, Education: Patient and Caregiver, Obesity: Weight Management, Obesity, Health Literacy
Zamudio J, Kanji FF, Lusk C
Identifying workflow disruptions in robotic-assisted bariatric surgery: elucidating challenges experienced by surgical teams.
The goal of this observational study was to investigate the impact of robotic bariatric surgery (RBS) on the surgical work system via the study of flow disruptions (FDs), or deviations from the natural workflow progression. Twenty-nine RBS procedures were observed at three sites; FDs were recorded in real time and subsequently classified into one of nine work system categories. FDs occurred approximately every 2.4 minutes and happened most frequently during the final patient transfer and robot docking phases of RBS. The coordination challenges that contributed most to these disruptions were associated with waiting for staff/instruments and readjusting equipment.
AHRQ-funded; HS026491.
Citation: Zamudio J, Kanji FF, Lusk C .
Identifying workflow disruptions in robotic-assisted bariatric surgery: elucidating challenges experienced by surgical teams.
Obes Surg 2023 Jul; 33(7):2083-89. doi: 10.1007/s11695-023-06620-4..
Keywords: Obesity: Weight Management, Surgery, Workflow, Obesity
Shen MR, Jiang S, Millis MA
Racial variation in baseline characteristics and wait times among patients undergoing bariatric surgery.
The purpose of this study was to examine whether differences exist in baseline characteristics or access to care between white and non-white patients of bariatric surgery. The researchers utilized a statewide bariatric-specific data registry and assessed all patients of bariatric surgery who completed a baseline questionnaire prior to the operation and compared data among racial groups. A total of 73,141 patients were included with 25.5% self-identifying as non-white. Non-white males were the least represented group with 4% of all bariatric surgery cases performed. Despite having higher rates of college education, when compared to white patients non-white patients were more likely to be younger, disabled, and have Medicaid. Despite having higher rates of patients with a body mass index above 50 kg/m the median time from the first evaluation to surgery was longer among non-white patients (157 days vs. 127 days.) The study concluded that despite presenting with higher rates of severe obesity, when compared with white patients non-white patients of bariatric surgery are an extremely diverse group with greater socioeconomic disadvantages and longer wait times.
AHRQ-funded; HS000053.
Citation: Shen MR, Jiang S, Millis MA .
Racial variation in baseline characteristics and wait times among patients undergoing bariatric surgery.
Surg Endosc 2023 Jan; 37(1):564-70. doi: 10.1007/s00464-022-09292-w..
Keywords: Racial and Ethnic Minorities, Surgery, Obesity: Weight Management, Obesity, Disparities
Chao GF, Chhabra KR, Yang J
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
The purpose of this study was to compare safety and healthcare use after sleeve gastrectomy versus Roux-en-Y gastric bypass in a national Medicare cohort. The researchers analyzed Medicare claims from 2012-2017 for 30,105 bariatric surgery patients receiving benefits due to age or disability and compared all outcomes between sleeve and bypass for each benefit group at 30 days, 1 year, and 3 years. The study found that among the disabled patients (n = 21,595), sleeve gastrectomy was associated with lower 3-year ED utilization, complications, reinterventions, rehospitalizations, and mortality. Cumulative expenditures were $46,277 after sleeve gastrectomy and $48,211 after gastric bypass. Among the elderly (n = 8510), sleeve was associated with lower 3-year ED utilization, complications, reinterventions, and rehospitalizations. Expenditures were $38,632 after sleeve gastrectomy and $39,270 after gastric bypass. Procedure treatment effect significantly differed by benefit group for paraesophageal hernia repair, revision, and mortality. The study concluded that healthcare utilization benefits of sleeve over bypass are maintained across Medicare elderly populations and Medicare disabled subpopulations.
AHRQ-funded; HS025778.
Citation: Chao GF, Chhabra KR, Yang J .
Bariatric surgery in Medicare patients: examining safety and healthcare utilization in the disabled and elderly.
Ann Surg 2022 Jul 1;276(1):133-39. doi: 10.1097/sla.0000000000004526..
Keywords: Obesity: Weight Management, Obesity, Surgery, Medicare, Elderly, Disabilities
Chhabra KR, Telem DA, Chao GF
Comparative safety of sleeve gastrectomy and gastric bypass: an instrumental variables approach.
This study compared the safety of sleeve gastrectomy versus gastric bypass surgery. Sleeve gastrectomy has become the most common bariatric surgery, rising from 52.6% in 2012 to 75% in 2016 among the cohort of 38,153 patients identified using commercially insured patients in the IBM MarketScan claims database. At 2 years from surgery, patients undergoing sleeve gastrectomy had fewer re-interventions (sleeve 9.9%, bypass 15.6%) and complications (sleeve 6.6%, bypass 9.6%), and lower overall healthcare spending ($47,891 vs $55,213), than patients undergoing gastric bypass. However, at the 2-year mark, revisions were slightly more common in sleeve gastrectomy than in gastric bypass (sleeve 0.6%, bypass 0.4%).
AHRQ-funded; HS025778.
Citation: Chhabra KR, Telem DA, Chao GF .
Comparative safety of sleeve gastrectomy and gastric bypass: an instrumental variables approach.
Ann Surg 2022 Mar;275(3):539-45. doi: 10.1097/sla.0000000000004297..
Keywords: Obesity: Weight Management, Obesity, Surgery, Patient Safety
Howard R, Chao GF, Yang J
Medication use for obesity-related comorbidities after sleeve gastrectomy or gastric bypass.
The purpose of this comparative effectiveness research study was to evaluate prior laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass patients and compare the incidence of medication discontinuation and restart of diabetes, hypertension, and hyperlipidemia medications. The researchers reviewed the records of adult Medicare beneficiaries who underwent sleeve gastrectomy or gastric bypass between January 1, 2012, to December 31, 2018, and had a claim for diabetes, hypertension, or hyperlipidemia medication in the 6 months before surgery with a corresponding diagnosis. The study found that when compared with sleeve gastrectomy, gastric bypass was associated with a slightly higher 5-year cumulative incidence of medication discontinuation among 30,588 patients with diabetes medication use and diagnosis at the time of surgery, 5,081 patients with antihypertensive medication use and diagnosis at the time of surgery and 35,055 patients with lipid-lowering medication use and diagnosis at the time of surgery. Among the patients who discontinued medication, gastric bypass was also associated with a slightly lower incidence of medication restart up to 5 years after discontinuation. The researchers concluded that gastric bypass was associated with a slightly higher incidence of medication discontinuation and a slightly lower incidence of medication restart among patients who discontinued medication than sleeve gastrectomy.
AHRQ-funded; HS025778; HS025365.
Citation: Howard R, Chao GF, Yang J .
Medication use for obesity-related comorbidities after sleeve gastrectomy or gastric bypass.
JAMA Surg 2022 Mar;157(3):248-56. doi: 10.1001/jamasurg.2021.6898..
Keywords: Obesity, Obesity: Weight Management, Surgery, Medication
Chhabra KR, Ghaferi AA, Yang J
Relationship between health care spending and clinical outcomes in bariatric surgery: implications for Medicare bundled payments.
This study’s objective was to evaluate sources of 90-day episode spending variation in Medicare patients undergoing bariatric surgery and whether spending variation was related to quality of care. A retrospective analysis of fee-for-service Medicare claims data from 761 acute care hospitals providing inpatient bariatric surgery was conducted between January 1, 2011 and September 30, 2016. Of 64,537 bariatric patients, 46% went sleeve gastrectomy, 22% revisited the emergency department (ED) within 90 days, and 12.5% were readmitted. Average 90-day payments were $14,124, ranging from $12,220 to $16,887. The largest components of spending variation were readmissions (44% of variation), post-acute care (19%), and index professional fees (15%). The lowest spending hospitals had the lowest complication, ED visit, post-acute utilization, and readmission rates.
AHRQ-funded; HS024403; HS023597.
Citation: Chhabra KR, Ghaferi AA, Yang J .
Relationship between health care spending and clinical outcomes in bariatric surgery: implications for Medicare bundled payments.
Ann Surg 2022 Feb;275(2):356-62. doi: 10.1097/sla.0000000000003979..
Keywords: Healthcare Costs, Surgery, Obesity, Outcomes
Tignanelli CJ, Bramante CT, Dutta NT
Metabolic surgery may protect against admission for COVID-19 in persons with nonalcoholic fatty liver disease.
SARS-CoV-2 (COVID-19) disease causes significant morbidity and mortality through increased inflammation and thrombosis. Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are states of chronic inflammation and indicate advanced metabolic disease. The purpose of this observational study was to characterize the risk of hospitalization for COVID-19 in patients with NAFLD/NASH and evaluate the mitigating effect of various metabolic treatments.
AHRQ-funded; HS026379.
Citation: Tignanelli CJ, Bramante CT, Dutta NT .
Metabolic surgery may protect against admission for COVID-19 in persons with nonalcoholic fatty liver disease.
Surg Obes Relat Dis 2021 Oct;17(10):1780-86. doi: 10.1016/j.soard.2021.05.029..
Keywords: COVID-19, Surgery, Obesity: Weight Management, Obesity
Montgomery JR, Waits SA, Dimick JB
Perioperative risks of sleeve gastrectomy versus roux-en-Y gastric bypass among patients with chronic kidney disease: a review of the MBSAQIP database.
The purpose of this study was to determine whether patients with chronic kidney disease experienced higher rates of perioperative complications after roux-en-Y gastric bypass (RYGB) compared to sleeve gastrectomy. The investigators concluded that among well-matched cohorts of RYGB and sleeve gastrectomy patients, incidence of primary outcomes were similar. Among secondary outcomes, only acute kidney injury was statistically-significantly higher among RYGB patients; however, the E-value for this difference was small and relatively weak confounder(s) could abrogate the statistical difference.
AHRQ-funded; HS025778.
Citation: Montgomery JR, Waits SA, Dimick JB .
Perioperative risks of sleeve gastrectomy versus roux-en-Y gastric bypass among patients with chronic kidney disease: a review of the MBSAQIP database.
Ann Surg 2021 Oct 1;274(4):e328-e35. doi: 10.1097/sla.0000000000003627..
Keywords: Surgery, Obesity, Kidney Disease and Health, Risk, Chronic Conditions
Yuce TK, Holmstrom A, Soper NJ
Complications and readmissions associated with first assistant training level following elective bariatric surgery.
Little is known regarding the variation in training level and potential clinical impact of the first assistant in bariatric surgery. In this study, the investigators described the postoperative 30-day complications and readmissions following elective bariatric procedures by training level of the first assistant. The investigators concluded that variation in training level of the first assist during bariatric surgery had no influence on DSM or readmissions.
AHRQ-funded; HS000078.
Citation: Yuce TK, Holmstrom A, Soper NJ .
Complications and readmissions associated with first assistant training level following elective bariatric surgery.
J Gastrointest Surg 2021 Aug;25(8):1948-54. doi: 10.1007/s11605-020-04787-0..
Keywords: Obesity: Weight Management, Obesity, Surgery, Hospital Readmissions, Adverse Events
Ehlers AP, Chhabra K, Thumma JR
In the eye of the beholder: surgeon variation in intra-operative perceptions of hiatal hernia and reflux outcomes after sleeve gastrectomy.
Researchers sought to determine whether intra-operative diagnosis of hiatal hernia varies among surgeons or if it affects outcomes of laparoscopic sleeve gastrectomy. They found that surgeons who identified hiatal hernias during video review had a higher rate of concurrent hiatal hernia repairs in their practice. However, this identification was not associated with improved patient-reported reflux symptoms after laparoscopic sleeve gastrectomy. They concluded that standardizing identification and management of hiatal hernias during bariatric surgery may help improve reflux outcomes post-operatively.
AHRQ-funded; HS023597.
Citation: Ehlers AP, Chhabra K, Thumma JR .
In the eye of the beholder: surgeon variation in intra-operative perceptions of hiatal hernia and reflux outcomes after sleeve gastrectomy.
Surg Endosc 2021 Jun;35(6):2537-42. doi: 10.1007/s00464-020-07668-4..
Keywords: Obesity, Surgery, Provider: Physician, Provider
Chhabra KR, Fan Z, Chao GF
The role of commercial health insurance characteristics in bariatric surgery utilization.
The goal of this study was to understand relationships among insurance plan type, out-of-pocket cost sharing, and the utilization of bariatric surgery among commercially insured patients. Over 73,000 commercially insured members of the IBM MarketScan commercial claims database who underwent bariatric surgery from 2014-17 were retroactively reviewed. Findings showed that insurance plan types with higher cost sharing have lower utilization of bariatric surgery.
AHRQ-funded; HS025778; HS000053.
Citation: Chhabra KR, Fan Z, Chao GF .
The role of commercial health insurance characteristics in bariatric surgery utilization.
Ann Surg 2021 Jun;273(6):1150-56. doi: 10.1097/sla.0000000000003569..
Keywords: Health Insurance, Obesity, Obesity: Weight Management, Surgery, Healthcare Costs, Healthcare Utilization
Shipe ME, Beeghly-Fadiel A, Deppen SA
Modeling the impact of delaying bariatric surgery due to COVID-19: a decision analysis.
In this study, the investigators developed a decision analysis model to evaluate risks and benefits of delaying scheduled bariatric surgery during the novel coronavirus disease (COVID-19) pandemic. Their base case was a 45-year-old female with diabetes and a body mass index of 45 kg/m(2). They compared immediate with delayed surgery after 6 months to allow for COVID-19 prevalence to decrease. The investigators found that immediate and delayed bariatric surgeries after 6 months resulted in similar 20-year overall survival.
AHRQ-funded; HS026122.
Citation: Shipe ME, Beeghly-Fadiel A, Deppen SA .
Modeling the impact of delaying bariatric surgery due to COVID-19: a decision analysis.
Obes Surg 2021 Mar;31(3):1387-91. doi: 10.1007/s11695-020-05054-6..
Keywords: Obesity: Weight Management, Obesity, COVID-19, Surgery, Shared Decision Making
Chhabra KR, Thumma JR, Varban OA
Associations between video evaluations of surgical technique and outcomes of laparoscopic sleeve gastrectomy.
The authors examined associations between technique and outcomes in laparoscopic sleeve gastrectomy. Technical approaches to five controversial aspects of laparoscopic sleeve gastrectomy were studied: dissection of the proximal stomach, sleeve caliber, sleeve anatomy, staple line reinforcement, and leak testing. The authors found that variations in surgical technique can be measured by video review and are associated with differences in patient outcomes.
AHRQ-funded; HS023597; HS025365.
Citation: Chhabra KR, Thumma JR, Varban OA .
Associations between video evaluations of surgical technique and outcomes of laparoscopic sleeve gastrectomy.
JAMA Surg 2021 Feb;156(2):e205532. doi: 10.1001/jamasurg.2020.5532..
Keywords: Surgery, Obesity, Provider Performance, Provider: Physician, Provider, Quality of Care
Varban OA, Thumma JR, Carlin AM
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
Global assessments of technical skill have been associated with surgical outcomes. More detailed understanding of which specific aspects of technique combine to make the "optimal" sleeve gastrectomy are necessary to help surgeons improve their practice. In this article, the investigators described their study in which the review of de-identified videos of practicing bariatric surgeons was conducted by a minimum of 10 peer surgeons. The videos were assessed on the technical quality of 9 operative maneuvers (ie mobilization of the fundus, stapler location, and sleeve width).
AHRQ-funded; HS017765.
Citation: Varban OA, Thumma JR, Carlin AM .
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
J Am Coll Surg 2020 Oct;231(4):470-77. doi: 10.1016/j.jamcollsurg.2020.06.016..
Keywords: Surgery, Obesity: Weight Management, Obesity, Adverse Events, Provider: Physician, Provider
Li X, Lewis KH, Callaway K
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
The authors assessed the availability and validity of claims-based weight-related diagnosis codes among bariatric surgery patients who underwent adjusted gastric banding, Roux-en-Y gastric bypass, or sleeve gastrectomy. They found that claims-based weight-related diagnosis codes had excellent validity before and after bariatric surgical operation but suboptimal availability after operation. Claims databases can be used for bariatric surgery studies of non-weight-related effectiveness and safety outcomes that are well-captured.
AHRQ-funded; HS026214.
Citation: Li X, Lewis KH, Callaway K .
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
BMC Med Res Methodol 2020 Sep 7;20(1):225. doi: 10.1186/s12874-020-01106-8..
Keywords: Obesity: Weight Management, Obesity, Surgery, Health Services Research (HSR), Research Methodologies
Yuce TK, Khorfan R, Soper NJ
Post-operative complications and readmissions associated with smoking following bariatric surgery.
The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. In this study, the investigators describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. The investigators concluded that smokers undergoing bariatric surgery experienced significantly worse 30-day outcomes when compared with non-smokers.
AHRQ-funded; HS000078.
Citation: Yuce TK, Khorfan R, Soper NJ .
Post-operative complications and readmissions associated with smoking following bariatric surgery.
J Gastrointest Surg 2020 Mar;24(3):525-30. doi: 10.1007/s11605-019-04488-3..
Keywords: Surgery, Tobacco Use, Adverse Events, Hospital Readmissions, Obesity: Weight Management, Obesity, Risk, Outcomes
de Meireles A, Carlin AM, Cain-Nielsen A
Association between surgeon practice knowledge and venous thromboembolism.
Venous thromboembolism (VTE) is the most common cause of mortality following bariatric surgery. This study aimed to determine practice patterns of VTE chemoprophylaxis among bariatric surgeons participating in a large statewide quality collaborative and compare the results of surgeon self-reported chemoprophylaxis prescription practices versus actual data from abstracted charts. They administered a 13-question survey to 66 surgeons to reveal VTE practice patterns such as medication type, dosage, timing, duration, and level of trainee involvement. They also examined the charts of all patients who had developed VTE during the study period and 15 other randomly selected patient charts per site. There was found to be a greater discordance between surgeon self-reported and actual perioperative VTE prophylaxis, but there was no significant discordance postoperatively. Greater perioperative discordance is associated with significantly increased risk of VTE.
AHRQ-funded; HS02362; HS024403.
Citation: de Meireles A, Carlin AM, Cain-Nielsen A .
Association between surgeon practice knowledge and venous thromboembolism.
Obes Surg 2020 Feb 16;30(6):2274-79. doi: 10.1007/s11695-020-04468-6..
Keywords: Surgery, Obesity: Weight Management, Obesity, Blood Clots, Practice Patterns, Provider: Physician, Provider
Kanters AE, Shubeck SP, Varban OA
Incidence and efficacy of stent placement in leak management after bariatric surgery: an MBSAQIP analysis.
The goal of this study was to evaluate the rates of use and efficacy of stent placement for postoperative leak following bariatric surgery. Using data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, findings showed that the use of stents can be effective; however, such use does not prevent reoperation and is associated with an increased likelihood of readmission. Recommendations included consideration of both technique and resource utilization when choosing a management pathway for leaks.
AHRQ-funded; HS000053; HS023597.
Citation: Kanters AE, Shubeck SP, Varban OA .
Incidence and efficacy of stent placement in leak management after bariatric surgery: an MBSAQIP analysis.
Ann Surg 2020 Jan;271(1):134-39. doi: 10.1097/sla.0000000000003023..
Keywords: Surgery, Obesity: Weight Management, Obesity, Adverse Events, Patient Safety, Outcomes
Dolan PT, Afaneh C, Dakin G
Lessons learned from developing a mobile app to assist in patient recovery after weight loss surgery.
This study examines the outcomes of patients recovering from weight loss surgery using a newly developed mobile app to help them recover successfully. The enrolled patients used the app for 30 days from July 2017 to October 2018. As the app was being used, it was updated. Ten patients were enrolled in the trial period with four using the initial version and six with the updated version. All patients were satisfied with the app and liked the notifications of updates. In the trial version only one patient completed at least 70% of the surveys, but five completed the surveys for the updated version. Next steps for the researchers is to conduct a pilot study with a larger set of patients.
AHRQ-funded; HS000066.
Citation: Dolan PT, Afaneh C, Dakin G .
Lessons learned from developing a mobile app to assist in patient recovery after weight loss surgery.
J Surg Res 2019 Dec;244:402-08. doi: 10.1016/j.jss.2019.06.063..
Keywords: Obesity: Weight Management, Obesity, Surgery, Telehealth, Health Information Technology (HIT)
Montgomery JR, Waits SA, Dimick JB
Risks of bariatric surgery among patients with end-stage renal disease.
Pretransplant morbid obesity among patients with end-stage renal disease (ESRD) is a significant predictor of delayed access to transplant and inferior posttransplant patient and kidney allograft outcomes. In this study, the authors performed an analysis of perioperative safety of bariatric surgery in obese patients with ESRD using a national registry capturing greater than 95% of bariatric operations.
AHRQ-funded; HS025778.
Citation: Montgomery JR, Waits SA, Dimick JB .
Risks of bariatric surgery among patients with end-stage renal disease.
JAMA Surg 2019 Dec;154(12):1160-62. doi: 10.1001/jamasurg.2019.2824..
Keywords: Surgery, Obesity, Obesity: Weight Management, Kidney Disease and Health, Transplantation, Risk, Chronic Conditions
Zhang T, Lary CW, Zullo AR
Post-hip fracture mortality in nursing home residents by obesity status.
This research letter discusses a study that examined whether obesity status affected mortality in post-hip fracture patients who were nursing home residents. A national cohort of nursing home (NH) residents was examined from national Medicare fee-for-service claims linked to the Minimum Data Set (MDS) from January 2008 through the end of 2009. A total of 33, 622 long-stay residents were identified who had been hospitalized for a hip fracture. They excluded 6918 patients due to a number of factors. They classified residents based on their BMI: normal BMI, overweight, mild obesity, or moderate/severe obesity. They found that being moderate/severely obese did not increase mortality.
AHRQ-funded; HS022998.
Citation: Zhang T, Lary CW, Zullo AR .
Post-hip fracture mortality in nursing home residents by obesity status.
J Am Geriatr Soc 2019 Sep;67(9):1983-85. doi: 10.1111/jgs.16028..
Keywords: Injuries and Wounds, Surgery, Nursing Homes, Obesity, Mortality, Elderly, Long-Term Care, Patient-Centered Outcomes Research
Sheetz KH, Woodside KJ, Shahinian VB
Trends in bariatric surgery procedures among patients with ESKD in the United States.
This study examined trends in bariatric surgery among patients with end-stage kidney disease (ESKD) in the United States. There was an almost ninefold increase in surgery between 2006 and 2016 for ESKD patients and also for sleeve gastrectomy surgery. ESKD patients showed similar complication rates compared with non-ESKD patients, but there were more readmissions.
AHRQ-funded; HS023597; HS000053.
Citation: Sheetz KH, Woodside KJ, Shahinian VB .
Trends in bariatric surgery procedures among patients with ESKD in the United States.
Clin J Am Soc Nephrol 2019 Aug 7;14(8):1193-99. doi: 10.2215/cjn.01480219..
Keywords: Obesity, Surgery, Kidney Disease and Health, Obesity: Weight Management, Hospital Readmissions, Adverse Events, Outcomes
Smith ME, Lee JS, Bonham A
Effect of new persistent opioid use on physiologic and psychologic outcomes following bariatric surgery.
In this study, the investigators sought to determine the relationship between new persistent opioid use and 1-year postoperative outcomes for patients undergoing bariatric surgery. The investigators concluded that new persistent opioid use is common following bariatric surgery and associated with significantly worse physiologic and psychologic outcomes. More effective screening and postoperative surveillance tools are needed to identify these patients, who likely require more aggressive counseling and treatment to maximize the benefits of bariatric surgery.
AHRQ-funded; HS024403.
Citation: Smith ME, Lee JS, Bonham A .
Effect of new persistent opioid use on physiologic and psychologic outcomes following bariatric surgery.
Surg Endosc 2019 Aug;33(8):2649-56. doi: 10.1007/s00464-018-6542-0..
Keywords: Opioids, Surgery, Medication, Obesity: Weight Management, Obesity, Obesity: Weight Management, Pain, Outcomes