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Fifth IFSO Global Registry Report

IFSO publishes Fifth IFSO Global Registry Report

This latest report includes 833,687 operation records from over 1,000 hospital across five continents
The report includes 294,530 RYGB procedures (35.3%), 391,423 SG procedures (47.0%), 70,085 LAGB procedures (8.4%) and 30,914 OAGB-MGB procedures (3.7%)

The Fifth IFSO Global Registry Report (2019) has been released at the XXIV World Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) in Madrid, Spain. Published by Dendrite Clinical Systems, under the auspices of the IFSO, the publication reports data from more than 60 countries on over 833,000 operations including baseline obesity-related disease, operation types, operative outcomes and disease status after bariatric surgery.

Global IFSO Registry Project

The report is the culmination of years of research and analyses from the IFSO Global Registry Project, which was established in January 2014 to demonstrate that it is possible to merge and analyse bariatric and metabolic surgical data from different countries and centres.

Almino Ramos

“Real and true data is the only way for convincing our peer specialties, governments, insurers, health care companies and the general community about the benefits of bariatric / metabolic surgery.  This is part of IFSO’s mission in establishing universal standards of care for the treatment of individuals with chronic adiposity-based disease,” said IFSO President, Professor Almino Ramos. “We believe that this Registry initiative is an important part of the IFSO global response to the adiposity epidemic, and we would like to encourage all our members and national societies to actively participate and join us in the next edition.”

This latest report includes 833,687 operation records from over 1,000 hospital across five continents, and has detailed information on:

  • 294,530 Roux en Y gastric bypass operations (35.3% of all operation records submitted)
  • 391,423 sleeve gastrectomy procedures (47.0%)
  • 70,085 gastric banding procedures (8.4%); and
  • 30,914 one anastomosis gastric bypass procedures (3.7%)

Overall, the proportion of female patients was 77.1% and there was a wide variation in country-specific gender ratios, ranging from 43.3% female (in Belgium) to 93.1% (in Guadeloupe). There was also a wide variation of BMI pre-surgery between different contributor countries, medians ranging from 36.4 kgm2 in Chile to 52.9kgm2 in Bulgaria, overall the BMI before surgery was 44.3 kgm2.

The report also noted a wide variation in the procedures performed between countries with the highest rates of sleeve gastrectomy operations were reported by Australia (a multi-centre contributor; 100% sleeve gastrectomy), Guadeloupe and Peru (both 100% sleeve gastrectomy, both represented by a single hospital). Whereas, Canada (84.3%), Colombia (80.7%) and Brazil (76.6%) reported the highest proportions of Roux en Y gastric bypass surgery.

Regarding co-morbidities prior to surgery, 23.3% of patients were on medication for type 2 diabetes, 41.0% were on medication for hypertension, 16.5% were on medication for depression, 12.0% were on medication for musculo-skeletal pain, 18.9% had sleep apnoea and 25.1% had gastro-oesophageal reflux disorder.

Outcomes

Following surgery, the report states that the patterns of post-operative stay are similar across most of the IFSO Chapters, with the exception of the Asia Pacific Chapter, where patients tend to stay a little longer in hospital after their surgery.  The reasons for this are not clear from the data however, they likely to be driven by organisational issues than anything to do to with the quality of surgery. On average, patients’ length-of-stay in hospital was 1.0 day after gastric banding, 1.9 days after sleeve gastrectomy, 2.1 days after Roux en Y gastric bypass and 2.8 days after OAGB-MGB.

Richard Welbourn

“Special credit must go to all those surgeons who have committed their data for inclusion in this fifth report, your contribution is very much appreciated,” writes Mr Richard Welbourn in the introduction of the report. “We intend in the future for the Registry data to become an increasingly authoritative reference work as metabolic and bariatric surgeons worldwide strive to increase the availability of this powerful tool to potential patients.”

One year after surgery, the average recorded percentage weight loss was 31.1% and during same period after primary surgery 64.2% of patients taking medication for type 2 diabetes no longer needed their medication; this was correlated with the weight loss achieved. There were similar reductions in the need for medication for hypertension (45.4% no longer required their medication) and dyslipidaemia (51.8% off medication). The report also noted improvements in other obesity-related conditions such as sleep apnoea and gastro-oesophageal reflux disorder, but the extent of these improvements seemed to vary from operation to operation.

Wendy Brown

“The IFSO Global Registry has achieved an enormous amount already. We are now poised to learn from this experience and move forward to provide not only the most accurate data available, but also support those Societies seeking to start their own registry,” writes Professor Wendy Brown, IFSO Global Registry Committee Chair. “I am very privileged to be a part of the team that is working on this initiative and I look forward to building on this very solid foundation of a fifth report.”

Peter Walton

“It has been very gratifying to see the Dendrite/IFSO Global Registry grow from its early beginnings to the substantial data and information resource it is today” said Dr Peter Walton, Managing Director of Dendrite Clinical Systems. “I would like to thank all the contributors for submitting their data and we look forward to working with IFSO and its members in producing additional reports over the next few years, which we hope will advance the status and acceptability of bariatric and metabolic surgery worldwide, helping promote an increase in bariatric and metabolic surgery provision.”

The Global IFSO Registry Project was headed by Almino Ramos (Brazil), Lillian Kow (Australia), Wendy Brown (Australia), John Dixon (Australia), Richard Welbourn (UK), Peter Walton and Robin Kinsman (Dendrite Clinical Systems Ltd, UK).

If you are interested in participating in the Sixth IFSO Global Registry Report, please email: ifsoregistry@e-dendrite.com for more information.

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