Questions and Answers
What was the main purpose of the study regarding prior sleeve gastrectomy patients?
What were the results regarding 90-day complications in the sleeve gastrectomy group compared to the obese control group?
How did postoperative revision rates compare between the sleeve gastrectomy group and the obese control group?
Which Patient-Reported Outcomes Measurement Information System (PROMIS) score significantly improved more in the control group compared to the sleeve gastrectomy group?
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What statistical method was used to evaluate the association of preoperative characteristics with outcomes?
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Study Notes
Study Purpose and Design
- Investigated the impact of prior sleeve gastrectomy on outcomes for patients undergoing total hip and knee arthroplasty.
- Analyzed 90-day complications, incidence of revision arthroplasty, and patient-reported outcomes post-surgery.
- Conducted as a retrospective, single-centre analysis with 80 patients in the sleeve gastrectomy group.
Control Group and Methodology
- Established a morbidly obese control group (1:2 ratio) from the same institutional registry.
- Matched cases and controls using a propensity score based on demographics, BMI, surgical codes, and presurgical HbA1C levels.
- Key outcomes measured included complications within 90 days, rates of revision arthroplasty, and final follow-up of patient-reported outcomes.
Key Findings
- Increased Complications: Sleeve gastrectomy patients had a significantly higher rate of complications within 90 days post-surgery (OR 4.00; 95% CI 1.14 to 13.9; p = 0.030).
- Revision Rates: No significant difference in revision surgery rates between sleeve gastrectomy and control groups (OR 17.8; 95% CI 0.64 to 494.3; p = 0.090).
- PROMIS Depression Scores: Greater improvement in PROMIS depression scores from pre- to postoperative in the obese control group than in the sleeve gastrectomy group (OR 4.04; 95% CI 0.06 to 8.02; p = 0.047).
- Pain and Function Outcomes: Changes in PROMIS pain interference and physical function scores were not influenced by sleeve gastrectomy status.
Conclusion
- Higher early complication rates observed in sleeve gastrectomy patients undergoing total arthroplasty compared to obese controls.
- Similar prosthetic revision rates suggest that prior weight loss through sleeve gastrectomy may not decrease surgical risks.
- Findings indicate that sleeve gastrectomy does not provide the anticipated benefits in mitigating early complications in obese individuals awaiting arthroplasty.
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Description
This study investigates the effects of prior sleeve gastrectomy on outcomes for patients undergoing total hip and knee arthroplasty. It assesses complications, revision rates, and patient-reported results following the procedures. With a focus on morbidly obese patients, the findings aim to provide insights into surgical implications for this demographic.
