Non vertebral Fracture Risk After Roux-en-Y Gastric Bypass
Elaine W. Yu, MD, from Massachusetts General Hospital in Boston, and colleagues compared fracture risk in obese adults after Roux-en-Y gastric bypass and adjustable gastric banding procedures using claims data from a US commercial health plan. They examined rates of non vertebral fractures within a propensity-score matched cohort of 15,032 morbidly obese adults who underwent Roux-en-Y gastric bypass or adjustable gastric banding surgery from 2005 to 2013.
During a mean follow-up of 2.3±1.9 years there were 281 non vertebral fractures. The researchers found that compared with adjustable gastric banding patients, Roux-en-Y gastric bypass patients had increased risk of non vertebral fracture (hazard ratio [HR]: 1.43). Roux-en-Y gastric bypass patients had increased risk of fracture at the hip and wrist (HR: 1.54 and 1.45, respectively) in fracture site-specific analyses. The risk of non-vertebral fracture associated with Roux-en-Y gastric bypass manifested more than 2 years after surgery and increased in subsequent years; the highest risk was seen in the fifth year after surgery (HR: 3.91).
“Fracture risk should be considered in risk:benefit discussions of bariatric surgery, particularly among patients with high baseline risk of osteoporosis who are deciding between Roux-en-Y gastric bypass and adjustable gastric banding procedures,” the authors write.
One author disclosed financial ties to the pharmaceutical industry.