Validation of Obesity Surgery Data in the Swedish National Patient Registry and Scandinavian Obesity Registry (SOReg)

Tao, Wenjing; Holmberg, Dag; Näslund, Erik; Näslund, Ingmar; Mattsson, Fredrik; Lagergren, Jesper; Ljung, Rickard

doi:10.1007/s11695-015-1994-y

Cited by 58 publications

(62 citation statements)

References 16 publications

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“…The nationwide and population‐based design with long and complete follow‐up of a large and unselected cohort is a strength of the study. The codes representing gastric bypass in the Patient Register were recently validated with excellent results . The assessment of reflux was based on the long‐term use of anti‐reflux medication, made prospectively through the use of data in a high‐quality and nationwide complete drug register, which allowed for accurate assessment of the outcome and complete follow‐up for several years.…”

Section: Discussionmentioning

confidence: 99%

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Gastric bypass surgery in the treatment of gastro‐oesophageal reflux symptoms

Holmberg

Santoni

Xie

et al. 2019

Aliment Pharmacol Ther

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Background: Gastric bypass is considered an effective treatment of co-existing gastro-oesophageal reflux (GERD) and obesity. Previous studies have had small sample sizes, short follow-up or substantial loss to follow-up. Aim:To assess the long-term risk of remaining/recurring reflux symptoms after gastric bypass. Methods:This was a nationwide cohort study of all adults with preoperative reflux who underwent gastric bypass in Sweden between 2006 and 2015, with complete follow-up through 2016. The outcome was remaining/recurring reflux symptoms, defined as use of proton pump inhibitors or histamine-2 receptor antagonists for >6 months after surgery. Cumulative incidence and risk factors of reflux were assessed with multivariable Poisson regression.Results: Among 2454 participants (81.7% female; mean age: 46.1 years, SD: 9.8 years), who were followed for median 4.6 years (interquartile range: 3.1-6.3 years), reflux recurred in 48.8% (95% confidence interval [95% CI], 46.8-51.0) of participants within 2 years of gastric bypass and remained stable up to 10 years after surgery (yearly change in incidence rate ratio [IRR] of 1.00; 95% CI, 0.99-1.02). Risk factors for recurring reflux were high preoperative dose of anti-reflux medication (IRR 1.77; 95% CI, 1.60-1.96 compared with low dose), older age (IRR 1.12; 95% CI 1.02-1.24 comparing age >50 with <40 years), female sex (IRR 1.28; 95% CI, 1.16-1.42) and comorbidity (IRR 1.26; 95% CI, 1.14-1.39 comparing Charlson Comorbidity Index ≥2 with 0). Conclusions:Reflux symptoms decrease rapidly after gastric bypass, but around half of operated patients require continuous anti-reflux medication. The treatment efficacy of gastric bypass on reflux symptoms might have been overestimated.

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Section: Discussionmentioning

confidence: 99%

“…The Patient Register has been validated for its usefulness in large‐scale, population‐based studies . The register was recently validated specifically for the recording of gastric bypass, showing high concordance (97%) and low misclassification (<3%) compared to medical records (n = 938) …”

Section: Methodsmentioning

confidence: 99%

Gastric bypass surgery in the treatment of gastro‐oesophageal reflux symptoms

Holmberg

Santoni

Xie

et al. 2019

Aliment Pharmacol Ther

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“…This study was based on a previously described Swedish database from 2007 to 2013, comprising all cholecystectomy events in the GallRiks register and all primary RYGB events in the SOReg register, cross‐matched where applicable using the Swedish personal identity number. RYGB revision surgery was not included in the database.…”

Section: Methodsmentioning

confidence: 99%

“…There is an increased risk of postoperative complications, including reoperation, when cholecystectomy is performed on patients who have previously undergone RYGB. That study was based on cross‐matched nationwide register data from the Swedish Register for Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (GallRiks) and the Scandinavian Obesity Surgery Registry (SOReg), 2007–2013. It is not known, however, whether the order in which cholecystectomy and RYGB are performed has an impact on the aggregate complication rate of the two procedures.…”

Section: Introductionmentioning

confidence: 99%

Morbidity of cholecystectomy and gastric bypass in a national database

Wanjura

Szabó

Österberg

et al. 2017

British Journal of Surgery

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Background: There is a strong association between obesity and gallstones. However, there is no clear evidence regarding the optimal order of Roux-en-Y gastric bypass (RYGB) and cholecystectomy when both procedures are clinically indicated.Methods: Based on cross-matched data from the Swedish Register for Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography (GallRiks; 79 386 patients) and the Scandinavian Obesity Surgery Registry (SOReg; 36 098 patients) from 2007 to 2013, complication rates, reoperation rates and operation times related to the timing of RYGB and cholecystectomy were explored.Results: There was a higher aggregate complication risk when cholecystectomy was performed after RYGB rather than before (odds ratio (OR) 1⋅35, 95 per cent c.i. 1⋅09 to 1⋅68; P = 0⋅006). A complication after the first procedure independently increased the complication risk of the following procedure (OR 2⋅02, 1⋅44 to 2⋅85; P < 0⋅001). Furthermore, there was an increased complication risk when cholecystectomy was performed at the same time as RYGB (OR 1⋅72, 1⋅14 to 2⋅60; P = 0⋅010). Simultaneous cholecystectomy added 61⋅7 (95 per cent c.i. 56⋅1 to 67⋅4) min (P < 0⋅001) to the duration of surgery.

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“…Thus adding clinical information from disease-specific quality registers (Emilsson et al 2015) can be useful (as discussed in Tip 1). Hopefully the diagnosis is already validated (Ludvigsson et al 2011;Razavi et al 2011;Tao et al 2015). If not, it may be necessary to validate the information available before the start of a major research project.…”

Section: Tipsmentioning

confidence: 99%

Enhancing evidence based medicine: Twelve tips for conducting register-based research

Brooke¹,

Holzmann²,

Olén³

et al. 2016

MedEdPublish

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With the increasing use of electronic health records for research, the need for clinicians to understand register-based research will become more important in the future. Based on our expertise we have compiled 12 tips for conducting register-based research. We aim to improve the subject knowledge of medical educators and those intending to critically appraise register-based studies. In addition, we aim to create a practical guide for those considering using register data in their own research. Our tips summarise characteristics of the research process specific to register-based research, from study design and ethical considerations, to validating the register and managing the data.

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Validation of Obesity Surgery Data in the Swedish National Patient Registry and Scandinavian Obesity Registry (SOReg)

Cited by 58 publications

References 16 publications

Gastric bypass surgery in the treatment of gastro‐oesophageal reflux symptoms

Gastric bypass surgery in the treatment of gastro‐oesophageal reflux symptoms

Morbidity of cholecystectomy and gastric bypass in a national database

Enhancing evidence based medicine: Twelve tips for conducting register-based research

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