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Early major complications after bariatric surgery in the USA, 2003–2014: a systematic review and meta‐analysis
Summary The effectiveness of bariatric surgery has been well‐studied. However, complications after bariatric surgery have been understudied. This review assesses
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| Published in: | Obesity reviews 2018-04, Vol.19 (4), p.529-537 |
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| Main Authors: | , , , , , , |
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| container_end_page | 537 |
| container_issue | 4 |
| container_start_page | 529 |
| container_title | Obesity reviews |
| container_volume | 19 |
| creator | Chang, S.‐H. Freeman, N. L. B. Lee, J. A. Stoll, C. R. T. Calhoun, A. J. Eagon, J. C. Colditz, G. A. |
| description | Summary
The effectiveness of bariatric surgery has been well‐studied. However, complications after bariatric surgery have been understudied. This review assesses |
| doi_str_mv | 10.1111/obr.12647 |
| format | article |
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The effectiveness of bariatric surgery has been well‐studied. However, complications after bariatric surgery have been understudied. This review assesses <30‐d major complications associated with bariatric procedures, including anastomotic leak, myocardial infarction and pulmonary embolism. This review included 71 studies conducted in the USA between 2003 and 2014 and 107,874 patients undergoing either gastric bypass, adjustable gastric banding or sleeve gastrectomy, with mean age of 44 years and pre‐surgery body mass index of 46.5 kg m−2. Less than 30‐d anastomotic leak rate was 1.15%; myocardial infarction rate was 0.37%; pulmonary embolism rate was 1.17%. Among all patients, mortality rate following anastomotic leak, myocardial infarction and pulmonary embolism was 0.12%, 0.37% and 0.18%, respectively. Among surgical procedures, <30‐d after surgery, sleeve gastrectomy (1.21% [95% confidence interval, 0.23–2.19%]) had higher anastomotic leak rate than gastric bypass (1.14% [95% confidence interval, 0.84–1.43%]); gastric bypass had higher rates of myocardial infarction and pulmonary embolism than adjustable gastric banding or sleeve gastrectomy. During the review, we found that the quality of complication reporting is lower than the reporting of other outcomes. In summary, <30‐d rates of the three major complications after either one of the procedures range from 0% to 1.55%. Mortality following these complications ranges from 0% to 0.64%. Future studies reporting complications after bariatric surgery should improve their reporting quality.</description><identifier>ISSN: 1467-7881</identifier><identifier>EISSN: 1467-789X</identifier><identifier>DOI: 10.1111/obr.12647</identifier><identifier>PMID: 29266740</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Anastomotic leak ; Anastomotic Leak - etiology ; Anastomotic Leak - mortality ; Banding ; bariatric surgery ; Bariatric Surgery - adverse effects ; Bariatric Surgery - mortality ; Body mass ; Body mass index ; Body size ; Bypasses ; Complications ; Confidence intervals ; Embolism ; Embolisms ; Gastrectomy ; Gastric bypass ; Gastrointestinal surgery ; Health risk assessment ; Heart attacks ; Humans ; Meta-analysis ; Mortality ; Myocardial infarction ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Obesity, Morbid - surgery ; Patients ; Postoperative Complications - mortality ; pulmonary embolism ; Pulmonary Embolism - etiology ; Pulmonary Embolism - mortality ; Pulmonary embolisms ; Surgery ; Systematic review ; Treatment Outcome ; United States - epidemiology</subject><ispartof>Obesity reviews, 2018-04, Vol.19 (4), p.529-537</ispartof><rights>2017 World Obesity Federation</rights><rights>2017 World Obesity Federation.</rights><rights>2018 World Obesity Federation</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3887-277d3c7e59d02caf9992e35469f5127d6c31b16495d034824f339b7b94a173a03</citedby><cites>FETCH-LOGICAL-c3887-277d3c7e59d02caf9992e35469f5127d6c31b16495d034824f339b7b94a173a03</cites><orcidid>0000-0001-5872-9556</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29266740$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, S.‐H.</creatorcontrib><creatorcontrib>Freeman, N. L. B.</creatorcontrib><creatorcontrib>Lee, J. A.</creatorcontrib><creatorcontrib>Stoll, C. R. T.</creatorcontrib><creatorcontrib>Calhoun, A. J.</creatorcontrib><creatorcontrib>Eagon, J. C.</creatorcontrib><creatorcontrib>Colditz, G. A.</creatorcontrib><title>Early major complications after bariatric surgery in the USA, 2003–2014: a systematic review and meta‐analysis</title><title>Obesity reviews</title><addtitle>Obes Rev</addtitle><description>Summary
The effectiveness of bariatric surgery has been well‐studied. However, complications after bariatric surgery have been understudied. This review assesses <30‐d major complications associated with bariatric procedures, including anastomotic leak, myocardial infarction and pulmonary embolism. This review included 71 studies conducted in the USA between 2003 and 2014 and 107,874 patients undergoing either gastric bypass, adjustable gastric banding or sleeve gastrectomy, with mean age of 44 years and pre‐surgery body mass index of 46.5 kg m−2. Less than 30‐d anastomotic leak rate was 1.15%; myocardial infarction rate was 0.37%; pulmonary embolism rate was 1.17%. Among all patients, mortality rate following anastomotic leak, myocardial infarction and pulmonary embolism was 0.12%, 0.37% and 0.18%, respectively. Among surgical procedures, <30‐d after surgery, sleeve gastrectomy (1.21% [95% confidence interval, 0.23–2.19%]) had higher anastomotic leak rate than gastric bypass (1.14% [95% confidence interval, 0.84–1.43%]); gastric bypass had higher rates of myocardial infarction and pulmonary embolism than adjustable gastric banding or sleeve gastrectomy. During the review, we found that the quality of complication reporting is lower than the reporting of other outcomes. In summary, <30‐d rates of the three major complications after either one of the procedures range from 0% to 1.55%. Mortality following these complications ranges from 0% to 0.64%. Future studies reporting complications after bariatric surgery should improve their reporting quality.</description><subject>Anastomotic leak</subject><subject>Anastomotic Leak - etiology</subject><subject>Anastomotic Leak - mortality</subject><subject>Banding</subject><subject>bariatric surgery</subject><subject>Bariatric Surgery - adverse effects</subject><subject>Bariatric Surgery - mortality</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Bypasses</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Embolism</subject><subject>Embolisms</subject><subject>Gastrectomy</subject><subject>Gastric bypass</subject><subject>Gastrointestinal surgery</subject><subject>Health risk assessment</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Obesity, Morbid - surgery</subject><subject>Patients</subject><subject>Postoperative Complications - mortality</subject><subject>pulmonary embolism</subject><subject>Pulmonary Embolism - etiology</subject><subject>Pulmonary Embolism - mortality</subject><subject>Pulmonary embolisms</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><issn>1467-7881</issn><issn>1467-789X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kctKJTEQhoMo6qgLX2AIuHHAo7l10nGn4g0EwQu4C9Xp9JhDX45Jt9I7H2Fg3tAnMXrUhWA2lcVXH1X1I7RJyS5Nb68rwi5lUqgFtEqFVBOV67vFr39OV9CvGKeEUKU5XUYrTDMplSCrKBxDqEfcwLQL2HbNrPYWet-1EUPVu4ALCB764C2OQ_jrwoh9i_t7h2-vD3YwI4S_PP9nhIp9DDiOsXdN6rc4uEfvnjC0JW5cDy_P_6CFeow-rqOlCuroNj7qGro9Ob45OptcXJ6eHx1cTCzPczVhSpXcKpfpkjALldaaOZ4JqauMMlVKy2lBpdBZSbjImag414UqtACqOBC-hrbn3lnoHgYXe9P4aF1dQ-u6IRqqlc5ILiVP6NY3dNoNIc0bTVqNMCUkF4n6M6ds6GIMrjKz4BsIo6HEvAVhUhDmPYjE_v4wDkXjyi_y8_IJ2JsDT752488mc3l4NVe-As8QkXc</recordid><startdate>201804</startdate><enddate>201804</enddate><creator>Chang, S.‐H.</creator><creator>Freeman, N. L. B.</creator><creator>Lee, J. A.</creator><creator>Stoll, C. R. T.</creator><creator>Calhoun, A. J.</creator><creator>Eagon, J. C.</creator><creator>Colditz, G. A.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7TS</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5872-9556</orcidid></search><sort><creationdate>201804</creationdate><title>Early major complications after bariatric surgery in the USA, 2003–2014: a systematic review and meta‐analysis</title><author>Chang, S.‐H. ; Freeman, N. L. B. ; Lee, J. A. ; Stoll, C. R. T. ; Calhoun, A. J. ; Eagon, J. C. ; Colditz, G. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3887-277d3c7e59d02caf9992e35469f5127d6c31b16495d034824f339b7b94a173a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Anastomotic leak</topic><topic>Anastomotic Leak - etiology</topic><topic>Anastomotic Leak - mortality</topic><topic>Banding</topic><topic>bariatric surgery</topic><topic>Bariatric Surgery - adverse effects</topic><topic>Bariatric Surgery - mortality</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Bypasses</topic><topic>Complications</topic><topic>Confidence intervals</topic><topic>Embolism</topic><topic>Embolisms</topic><topic>Gastrectomy</topic><topic>Gastric bypass</topic><topic>Gastrointestinal surgery</topic><topic>Health risk assessment</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Meta-analysis</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - mortality</topic><topic>Obesity, Morbid - surgery</topic><topic>Patients</topic><topic>Postoperative Complications - mortality</topic><topic>pulmonary embolism</topic><topic>Pulmonary Embolism - etiology</topic><topic>Pulmonary Embolism - mortality</topic><topic>Pulmonary embolisms</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, S.‐H.</creatorcontrib><creatorcontrib>Freeman, N. L. B.</creatorcontrib><creatorcontrib>Lee, J. A.</creatorcontrib><creatorcontrib>Stoll, C. R. T.</creatorcontrib><creatorcontrib>Calhoun, A. J.</creatorcontrib><creatorcontrib>Eagon, J. C.</creatorcontrib><creatorcontrib>Colditz, G. A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Physical Education Index</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, S.‐H.</au><au>Freeman, N. L. B.</au><au>Lee, J. A.</au><au>Stoll, C. R. T.</au><au>Calhoun, A. J.</au><au>Eagon, J. C.</au><au>Colditz, G. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early major complications after bariatric surgery in the USA, 2003–2014: a systematic review and meta‐analysis</atitle><jtitle>Obesity reviews</jtitle><addtitle>Obes Rev</addtitle><date>2018-04</date><risdate>2018</risdate><volume>19</volume><issue>4</issue><spage>529</spage><epage>537</epage><pages>529-537</pages><issn>1467-7881</issn><eissn>1467-789X</eissn><abstract>Summary
The effectiveness of bariatric surgery has been well‐studied. However, complications after bariatric surgery have been understudied. This review assesses <30‐d major complications associated with bariatric procedures, including anastomotic leak, myocardial infarction and pulmonary embolism. This review included 71 studies conducted in the USA between 2003 and 2014 and 107,874 patients undergoing either gastric bypass, adjustable gastric banding or sleeve gastrectomy, with mean age of 44 years and pre‐surgery body mass index of 46.5 kg m−2. Less than 30‐d anastomotic leak rate was 1.15%; myocardial infarction rate was 0.37%; pulmonary embolism rate was 1.17%. Among all patients, mortality rate following anastomotic leak, myocardial infarction and pulmonary embolism was 0.12%, 0.37% and 0.18%, respectively. Among surgical procedures, <30‐d after surgery, sleeve gastrectomy (1.21% [95% confidence interval, 0.23–2.19%]) had higher anastomotic leak rate than gastric bypass (1.14% [95% confidence interval, 0.84–1.43%]); gastric bypass had higher rates of myocardial infarction and pulmonary embolism than adjustable gastric banding or sleeve gastrectomy. During the review, we found that the quality of complication reporting is lower than the reporting of other outcomes. In summary, <30‐d rates of the three major complications after either one of the procedures range from 0% to 1.55%. Mortality following these complications ranges from 0% to 0.64%. Future studies reporting complications after bariatric surgery should improve their reporting quality.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29266740</pmid><doi>10.1111/obr.12647</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5872-9556</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anastomotic leak Anastomotic Leak - etiology Anastomotic Leak - mortality Banding bariatric surgery Bariatric Surgery - adverse effects Bariatric Surgery - mortality Body mass Body mass index Body size Bypasses Complications Confidence intervals Embolism Embolisms Gastrectomy Gastric bypass Gastrointestinal surgery Health risk assessment Heart attacks Humans Meta-analysis Mortality Myocardial infarction Myocardial Infarction - etiology Myocardial Infarction - mortality Obesity, Morbid - surgery Patients Postoperative Complications - mortality pulmonary embolism Pulmonary Embolism - etiology Pulmonary Embolism - mortality Pulmonary embolisms Surgery Systematic review Treatment Outcome United States - epidemiology |
| title | Early major complications after bariatric surgery in the USA, 2003–2014: a systematic review and meta‐analysis |
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