Elizaveta Walker1, Miriam Elman2, Erin E Takemoto2, Erin Fennern3, James E Mitchell4, Walter J Pories5, Bestoun Ahmed6, Alfons Pomp7, Bruce M Wolfe1. 1. Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA. 2. School of Public Health, Oregon Health and Science University, Portland, Oregon, USA. 3. Department of Surgery, University of Washington Medical Center, Seattle, Washington, USA. 4. Department of Psychiatry and Behavioral Science, University of North Dakota, Fargo, North Dakota, USA. 5. Department of Surgery, East Carolina University, Greenville, North Carolina, USA. 6. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 7. Department of Surgery, Weill Cornell Medical College, New York, New York, USA.
Abstract
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.
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 NMparticipants 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 NMparticipants 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 NMparticipants.
Authors: David C W Lau; James D Douketis; Katherine M Morrison; Irene M Hramiak; Arya M Sharma; Ehud Ur Journal: CMAJ Date: 2007-04-10 Impact factor: 8.262
Authors: Steven H Belle; Paul D Berk; Anita P Courcoulas; David R Flum; Carolyn W Miles; James E Mitchell; Walter J Pories; Bruce M Wolfe; Susan Z Yanovski Journal: Surg Obes Relat Dis Date: 2007 Mar-Apr Impact factor: 4.734
Authors: Steven H Belle; Paul D Berk; William H Chapman; Nicholas J Christian; Anita P Courcoulas; Greg F Dakin; David R Flum; Mary Horlick; Wendy C King; Carol A McCloskey; James E Mitchell; Emma J Patterson; John R Pender; Kristine J Steffen; Richard C Thirlby; Bruce M Wolfe; Susan Z Yanovski Journal: Surg Obes Relat Dis Date: 2013-03-07 Impact factor: 4.734