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Bariatric Surgery Among Medicare Subgroups: Short‐ and Long‐Term Outcomes
Author(s) -
Walker Elizaveta,
Elman Miriam,
Takemoto Erin E.,
Fennern Erin,
Mitchell James E.,
Pories Walter J.,
Ahmed Bestoun,
Pomp Alfons,
Wolfe Bruce M.
Publication year - 2019
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.22613
Subject(s) - medicine , adverse effect , weight loss , gastric bypass , diabetes mellitus , observational study , type 2 diabetes , surgery , cohort study , cohort , weight change , obesity , gastric bypass surgery , endocrinology
Objective This study sought to examine weight change, postoperative adverse events, and related outcomes of interest among age‐qualified (AQ) and disability‐qualified (DQ) Medicare recipients compared with non‐Medicare (NM) patients undergoing an initial bariatric procedure. Methods The Longitudinal Assessment of Bariatric Surgery (LABS‐2) is an observational cohort study of 2,458 adults who underwent Roux‐en‐Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB) bariatric surgery. Weight, percentage body fat, functional status, and comorbidities, as well as postoperative adverse events, were assessed at baseline and annually for 5 years. The 1,943 participants who reported insurance type were categorized into the following groups: AQ, DQ, or NM. Results The median preoperative BMI ranged from 45 to 48 kg/m 2 across groups. For RYGB, 5‐year BMI loss was approximately 30% for all groups, and for LAGB, BMI loss was 12% to 15%. Diabetes remission after 5 years was also similar across groups within procedure types (RYGB: 33%‐40%; LAGB: 13%‐19%). The frequency of adverse events after RYGB ranged from 4.1% for NM participants to 6.7% for DQ participants. After LAGB, there were no adverse events for the AQ group, whereas 3% of DQ participants and 1.8% of NM participants had at least one adverse event. Conclusions Medicare participants experienced substantial BMI loss and diabetes remission, with a frequency of adverse events similar to that of NM participants.