Long-term incidence of serious fall-related injuries after bariatric surgery in Swedish obese subjects

• Published in: International Journal of Obesity Vol. 43; no. 4; pp. 933 - 937
• Main Authors: Carlsson, Lena M. S., Sjöholm, Kajsa, Ahlin, Sofie, Jacobson, Peter, Andersson-Assarsson, Johanna C., Karlsson Lindahl, Linda, Maglio, Cristina, Karlsson, Cecilia, Hjorth, Stephan, Taube, Magdalena, Carlsson, Björn, Svensson, Per-Arne, Peltonen, Markku
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.04.2019; Nature Publishing Group
• Subjects: 692/163; 692/499; 692/699/2743/393; Accidental falls; Accidental Falls - prevention & control; Accidental Falls - statistics & numerical data; Adult; Analysis; Bariatric surgery; Body mass index; Body size; Brief Communication; Care and treatment; Endocrinology and Diabetes; Endokrinologi och diabetes; Epidemiology; Female; Follow-Up Studies; Gastric bypass; Gastric Bypass - adverse effects; Gastrointestinal surgery; Gastroplasty; Health Promotion and Disease Prevention; Humans; Incidence; Injuries; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Obesity; Obesity, Morbid - physiopathology; Obesity, Morbid - surgery; Patient outcomes; Proportional Hazards Models; Prospective Studies; Public Health; Rank tests; Risk factors; Statistics; Surgery; Sweden - epidemiology; Treatment Outcome; Type 2 diabetes; Sweden
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/s41366-018-0097-y

Obesity increases risk of falling, but the effect of bariatric surgery on fall-related injuries is unknown. The aim of this study was therefore to study the association between bariatric surgery and long-term incidence of fall-related injuries in the prospective, controlled Swedish Obese Subjects study. At inclusion, body mass index was ≥ 34 kg/m 2 in men and ≥38 kg/m 2 in women. The surgery per-protocol group ( n  = 2007) underwent gastric bypass ( n  = 266), banding ( n  = 376), or vertical banded gastroplasty ( n  = 1365), and controls ( n  = 2040) received usual care. At the time of analysis (31 December 2013), median follow-up was 19 years (maximal 26 years). Fall-related injuries requiring hospital treatment were captured using data from the Swedish National Patient Register. During follow-up, there were 617 first-time fall-related injuries in the surgery group and 513 in the control group (adjusted hazard ratio 1.21, 95% CI, 1.07–1.36; P  = 0.002). The incidence differed between treatment groups ( P  < 0.001, log-rank test) and was higher after gastric bypass than after usual care, banding and vertical banded gastroplasty (adjusted hazard ratio 0.50–0.52, P  < 0.001 for all three comparisons). In conclusion, gastric bypass surgery was associated with increased risk of serious fall-related injury requiring hospital treatment.