Evidence map›Paper›PMID 36036493›Full record

ArticleAnnals of surgery2023

Comparative Safety of Sleeve Gastrectomy and Gastric Bypass up to 5 Years After Surgery in Patients With Medicaid.

Ryan Howard, Jie Yang, Jyothi Thumma, Anne Ehlers, Sean O'Neill, David Arterburn, Andrew Ryan, Dana Telem, Justin B Dimick

Open access · greenAbstract read
In one paragraph

Article in Annals of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Ryan HowardDepartment of Surgery, University of Michigan, Ann Arbor, MI.ORCID 0000-0001-9877-9603
Jie YangCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI.
Jyothi ThummaCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI.
Anne EhlersDepartment of Surgery, University of Michigan, Ann Arbor, MI.
Sean O'NeillDepartment of Surgery, University of Michigan, Ann Arbor, MI.
David ArterburnKaiser Permanente Washington Health Research Institute, Seattle, WA.
Andrew RyanCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI.
Dana TelemDepartment of Surgery, University of Michigan, Ann Arbor, MI.
Justin B DimickDepartment of Surgery, University of Michigan, Ann Arbor, MI.
University of Michigan · USKaiser Permanente Washington Health Research Institute · US

Funding

Long-Term Comparative Safety and Economic Outcomes of Sleeve GastrectomyR01DK115408 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DIMICK, JUSTIN BRIGHAM · 2018 to 2021
$2.5M
Obesity Surgery Scientist Training ProgramT32DK108740 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Justin Brigham Dimick, RANDY J SEELEY · 2016 to 2026
$2.2M
NIDDK NIH HHS R01 DK115408NIDDK NIH HHS T32 DK108740
6 · The paper itself

Abstract

objectiveCompare adverse outcomes up to 5 years after sleeve gastrectomy and gastric bypass in patients with Medicaid.

backgroundSleeve gastrectomy is the most common bariatric operation among patients with Medicaid; however, its long-term safety in this population is unknown.

methodsUsing Medicaid claims, we performed a retrospective cohort study of adult patients who underwent sleeve gastrectomy or gastric bypass from January 1, 2012, to December 31, 2018. Instrumental variables survival analysis was used to estimate the cumulative incidence and heterogeneity of outcomes up to 5 years after surgery.

resultsAmong 132,788 patients with Medicaid, 84,717 (63.8%) underwent sleeve gastrectomy and 48,071 (36.2%) underwent gastric bypass. A total of 69,225 (52.1%) patients were White, 33,833 (25.5%) were Black, and 29,730 (22.4%) were Hispanic. Compared with gastric bypass, sleeve gastrectomy was associated with a lower 5-year cumulative incidence of mortality (1.29% vs 2.15%), complications (11.5% vs 16.2%), hospitalization (43.7% vs 53.7%), emergency department (ED) use (61.6% vs 68.2%), and reoperation (18.5% vs 22.8%), but a higher cumulative incidence of revision (3.3% vs 2.0%). Compared with White patients, the magnitude of the difference between sleeve and bypass was smaller among Black patients for ED use [5-y adjusted hazard ratios: 1.01; 95% confidence interval (CI), 0.94-1.08 vs 0.94 (95% CI, 0.88-1.00), P <0.001] and Hispanic patients for reoperation [5-y adjusted hazard ratios: 0.95 (95% CI, 0.86-1.05) vs 0.76 (95% CI, 0.69-0.83), P <0.001].

conclusionsAmong patients with Medicaid undergoing bariatric surgery, sleeve gastrectomy was associated with a lower risk of mortality, complications, hospitalization, ED use, and reoperations, but a higher risk of revision compared with gastric bypass. Although the difference between sleeve and bypass was generally similar among White, Black, and Hispanic patients, the magnitude of this difference was smaller among Black patients for ED use and Hispanic patients for reoperation.

Indexed as

Gastric BypassLaparoscopyObesity, MorbidAdultGastrectomyHumansMedicaidPostoperative ComplicationsRetrospective StudiesTreatment Outcome

Identifiers

PMID36036493
PMCPMC9971342
OpenAlexW4293453012

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.