Olivia Lovrics1, Aristithes G Doumouras2, Scott Gmora2, Mehran Anvari2, Dennis Hong2. 1. Division of General Surgery, St. Joseph's Healthcare, Hamilton, Ontario, Canada. Electronic address: Olivia.lovrics@medportal.ca. 2. Division of General Surgery, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Abstract
BACKGROUND: In 2013, 18% of Canadian adults had obesity (body mass index [BMI] >30 kg/m2), compared with 25.7% of Canada's Indigenous population. Bariatric surgery is an effective treatment for obesity, but has not been studied in Canadian Indigenous populations. OBJECTIVES: To determine the effects of bariatric surgery in the Indigenous Ontario population. SETTING: Multicenter data from the publicly funded Ontario bariatric program and registry. METHODS: Prospectively collected data using all surgical patients between March 2010 and 2018 was included in initial analysis and included the following postoperative outcomes: diabetes, hypertension, and gastroesophageal reflux disease. Demographic characteristics, baseline characteristics, and univariate outcomes were assessed using Pearson Χ2 or t tests. Multivariable regression for BMI change was used with complete case analysis and multiple imputation. RESULTS: Of 16,629 individuals initially identified, 338 self-identified as Indigenous, 13,502 as Non-Indigenous, and 2789 omitted ethnicity and were excluded. Baseline demographic characteristics were not statistically different; rates of hypertension (P = .03) and diabetes (P < .001) were higher in the Indigenous population. Univariable analysis showed similar 1-year BMI change (Indigenous: 15.8 ± 6.0 kg/m2; Non-Indigenous: 16.1 ± 5.6 kg/m2, P = .362). After adjustment, BMI change was not different between groups at 6 months (effect size = .07, 95% confidence interval -.45 to .58, P = .803) and 1 year (effect size = -.24, 95% confidence interval -.93 to .45, P = .489). Rates of co-morbidities were similar at 1 year between the 2 populations, despite differences at baseline. Six-month and 1-year follow-up rates were higher in the Non-Indigenous population (P < .001, P = .005, respectively). CONCLUSIONS: Weight loss and resolution of obesity-related co-morbidities are similar in Indigenous and Non-Indigenous patients. Access to surgery, patient selection, and long-term results merit further investigation.
BACKGROUND: In 2013, 18% of Canadian adults had obesity (body mass index [BMI] >30 kg/m2), compared with 25.7% of Canada's Indigenous population. Bariatric surgery is an effective treatment for obesity, but has not been studied in Canadian Indigenous populations. OBJECTIVES: To determine the effects of bariatric surgery in the Indigenous Ontario population. SETTING: Multicenter data from the publicly funded Ontario bariatric program and registry. METHODS: Prospectively collected data using all surgical patients between March 2010 and 2018 was included in initial analysis and included the following postoperative outcomes: diabetes, hypertension, and gastroesophageal reflux disease. Demographic characteristics, baseline characteristics, and univariate outcomes were assessed using Pearson Χ2 or t tests. Multivariable regression for BMI change was used with complete case analysis and multiple imputation. RESULTS: Of 16,629 individuals initially identified, 338 self-identified as Indigenous, 13,502 as Non-Indigenous, and 2789 omitted ethnicity and were excluded. Baseline demographic characteristics were not statistically different; rates of hypertension (P = .03) and diabetes (P < .001) were higher in the Indigenous population. Univariable analysis showed similar 1-year BMI change (Indigenous: 15.8 ± 6.0 kg/m2; Non-Indigenous: 16.1 ± 5.6 kg/m2, P = .362). After adjustment, BMI change was not different between groups at 6 months (effect size = .07, 95% confidence interval -.45 to .58, P = .803) and 1 year (effect size = -.24, 95% confidence interval -.93 to .45, P = .489). Rates of co-morbidities were similar at 1 year between the 2 populations, despite differences at baseline. Six-month and 1-year follow-up rates were higher in the Non-Indigenous population (P < .001, P = .005, respectively). CONCLUSIONS:Weight loss and resolution of obesity-related co-morbidities are similar in Indigenous and Non-Indigenous patients. Access to surgery, patient selection, and long-term results merit further investigation.
Authors: Jean-Eric Tarride; Aristithes G Doumouras; Dennis Hong; J Michael Paterson; Semra Tibebu; Francis Nguyen; Richard Perez; Valerie H Taylor; Feng Xie; Vanessa Boudreau; Eleanor Pullenayegum; David R Urbach; Mehran Anvari Journal: JAMA Netw Open Date: 2021-09-01
Authors: Jean-Eric Tarride; Aristithes G Doumouras; Dennis Hong; J Michael Paterson; Semra Tibebu; Richard Perez; Julia Ma; Valerie H Taylor; Feng Xie; Vanessa Boudreau; Eleanor Pullenayegum; David R Urbach; Mehran Anvari Journal: JAMA Surg Date: 2020-09-16 Impact factor: 14.766