bariatric surgery

Novel Tool Can Predict Impact of Bariatric Surgery on Long-Term Mortality, Morbidity Rates

A new web-based risk calculator can predict the 7-year morbidity and mortality rates among patients with type 2 diabetes (T2DM) and obesity for 2 potential situations: whether they receive bariatric surgery or whether they continue with standard medical treatment. The new research was presented at ObesityWeek 2019.

To estimate the risk of long-term end-organ complications and mortality in patients with T2DM and obesity who are considering bariatric surgery, the researchers constructed accurate predictive models and integrated them into the new Individualized Diabetes Complications (IDC) Risk Calculator.

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According to the study authors, the risk calculation is measured based on several factors, including the patient’s age, medical history, body mass index (BMI), diabetes control, and medication usage.2

The researchers identified 2287 patients with T2DM and obesity (BMI of 30 kg/m2 or greater) in the Cleveland Clinic Health System between 2004 and 2017 who had undergone bariatric surgery and matched them 1:5 with 11,435 control patients. The patients were matched based on the index date, age, sex, BMI, site, insulin use, and presence of diabetes complications and were followed through December 2018.

The researchers evaluated the prediction tools’ discrimination ability to determine the long-term risk for 5 outcomes of interest—all-cause mortality, coronary artery disease, cerebrovascular event, heart failure, and nephropathy—averaged over 5 to 7 years.

After determining that the IDC Risk Scores were accurate, the researchers integrated the scores into web-based and smartphone applications for clinical use. Users can enter their data into the application, and the 7-year morbidity and mortality rates with and without having bariatric surgery are revealed. 

“The IDC Risk Calculator can provide a glimpse into the future for individuals with diabetes and obesity, and demonstrate the impact usual medical care versus metabolic surgery would have on their risk of death or major complications,” said lead study author Ali Aminian, MD, from the Cleveland Clinic. “This can better inform treatment decisions and doctor recommendations, and hopefully lead to improved patient care and outcomes.”2

—Colleen Murphy

References:

  1. Aminian A, Zajichek A, Arterburn DE, et al. A101 – Individualized Diabetes Complications Risk Scores: future risk of diabetes end-organ complications with and without metabolic surgery. Paper presented at: ObesityWeek 2019; November 3-7, 2019; Las Vegas, NV. https://obesityweek.com/abstract/individualized-diabetes-complications-risk-scores-future-risk-of-diabetes-end-organ-complications-with-and-without-metabolic-surgery/. Accessed November 6, 2019.
  2. Web-based calculator predicts risk of death, complications from diabetes and obesity [press release]. Las Vegas, NV: American Society for Metabolic and Bariatric Surgery; November 5, 2019. https://asmbs.org/articles/web-based-calculator-predicts-risk-of-death-complications-from-diabetes-and-obesity. Accessed November 6, 2019.