Weight Loss Prior to Bariatric Surgery and 30-Day Mortality, Readmission, Reoperation, and Intervention: an MBSAQIP Analysis of 349,016 Cases

Tewksbury, Colleen; Crowley, Nina; Parrott, J.; Andromalos, Laura; Isom, Kellene; Smith, Elizabeth; Allison, Kelly C.

doi:10.1007/s11695-019-04041-w

Cited by 23 publications

(18 citation statements)

References 19 publications

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“…Regardless of preoperative weight loss continuing to be a debated topic due to contradictory publications, clinically there are multiple advantages of implementing pre-operative weight loss in patients with obesity. Preoperative weight loss has demonstrated decrease in the size of the liver and the thickness of the abdominal wall, allowing the surgery to be technically easier (15). Excess visceral fat and a high liver volume are known to complicate the technical aspects of bariatric surgery because they can increase the blood loss volume, operating time, and risk of complications (16,17).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Off Label Utilization of Topiramate and Metformin in Patients With BMI ≥50 kg/m2 Prior to Bariatric Surgery

2021

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FDA approved anti-obesity medications may not be cost effective for patients struggling with pre-operative weight loss prior to bariatric surgery. Metformin, a biguanide, and Topiramate, a carbonic anhydrase inhibitor, both cost effective medications, have demonstrated weight loss when used for the treatment of type 2 diabetes or seizures, respectively. The aim of the three cases is to demonstrate the clinical utility of topiramate and metformin for preoperative weight loss in patients with a body mass index (BMI) ≥ 50 kg/m2 prior to bariatric surgery who are unable to follow the bariatric nutritional prescription due to a dysregulated appetite system Each patient was prescribed metformin and/or topiramate in an off-label manner in conjunction with lifestyle modifications and achieved >8% total body weight loss during the preoperative period.

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Section: Discussionmentioning

confidence: 99%

Case Report: Off Label Utilization of Topiramate and Metformin in Patients With BMI ≥50 kg/m2 Prior to Bariatric Surgery

2021

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“…Much larger cohort studies, such as the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MSAQIBP) which enrolled patients from the USA and Canada, have demonstrated convincingly that 30-day mortality in bariatric surgical patients is inversely proportional to body mass index (BMI) as well as the magnitude of weight loss prior to surgery [ 16 ]. Interestingly, however, the same analysis by a different group of authors of the same cohort 1 year previously had found no such associations, but rather an increased risk of surgical site and urinary tract infections in those with lower BMI [ 17 ]. This highlights the inherent limitations of even very large and well-conducted retrospective cohort studies.…”

Section: Does Weight Loss Before Bariatric Surgery Improve Outcomes?mentioning

confidence: 99%

Structured Lifestyle Modification Prior to Bariatric Surgery: How Much is Enough?

Brazil

Finucane

2021

OBES SURG

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Many healthcare systems require patients to participate in a structured lifestyle modification programme prior to bariatric surgery, even though bariatric consensus guidelines do not recommend this. While there is good evidence that such programmes improve health in other conditions such as metabolic and cardiovascular diseases, there is no evidence that they improve outcomes after bariatric surgery. The distinction needs to be drawn between the well-established need for individualised multidisciplinary dietetic and physical activity care for bariatric surgical patients and the potential harms from mandating participation in compulsory structured lifestyle programmes of fixed duration, frequency and intensity, which may delay surgery, reinforce obesity stigma, or both. Large clinical trials might help to address some of the uncertainty and provide an evidence base for clinicians and policymakers. Graphical abstract

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“…Ultimately, the preoperative assessment process took 218 days; on average this assessment period takes 195 days. 16…”

Section: Sarwermentioning

confidence: 99%

Multidisciplinary Assessment and Management of a Complex Patient Who Underwent Bariatric Surgery for Clinically Severe Obesity: A Case Report

Sarwer¹

2021

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Weight Loss Prior to Bariatric Surgery and 30-Day Mortality, Readmission, Reoperation, and Intervention: an MBSAQIP Analysis of 349,016 Cases

Cited by 23 publications

References 19 publications

Case Report: Off Label Utilization of Topiramate and Metformin in Patients With BMI ≥50 kg/m2 Prior to Bariatric Surgery

Case Report: Off Label Utilization of Topiramate and Metformin in Patients With BMI ≥50 kg/m2 Prior to Bariatric Surgery

Structured Lifestyle Modification Prior to Bariatric Surgery: How Much is Enough?

Multidisciplinary Assessment and Management of a Complex Patient Who Underwent Bariatric Surgery for Clinically Severe Obesity: A Case Report

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