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Scottish study

SCOTS to examine long term clinical outcomes for surgery

2,000 patients will be followed out to ten years
Study will focus on ten-year mortality and additional outcomes

Researchers from the University of Glasgow are assessing the long term outcomes and complications of bariatric surgery in Scotland. This twelve-year study will be the most detailed study of the long term benefits and complications of bariatric surgery to date.

The Surgical Obesity Treatment Study (SCOTS) is seeking to recruit more than 2,000 patients undergoing bariatric surgery in Scotland, and it is estimated some 400 patients will be recruited annually. Approximately, 500 bariatric procedures are carried out across the NHS and private health services in Scotland each year. 

The study, which is led by Dr Jennifer Logue, Clinical Lecturer in Metabolic Medicine at the University of Glasgow, has received £2.1 million grant from the National Institute of Health Research (NIHR) Health Technology Assessment programme. The funding will enable patients to be followed for an average of ten years after their surgery (until July 2026).

Dr Jennifer Logue

“While evidence has shown that the surgery can help patients to achieve significant weight loss and reduce the incidence of illnesses such as diabetes in the short term, there is a lack of up-to-date research on the long-term outcomes for those who undergo the procedure,” said Dr Logue. “This will be one of the largest and most in depth studies of the effects of bariatric surgery and we’re confident our results will have relevance to healthcare professionals across the world.”

The study primary endpoint will be ten year mortality, but it will also report on: change in weight, incidence type 2 diabetes, cardiovascular disease (CVD), cancer, fractures, incidence of nutritional deficiencies, health-related quality of life, glycaemic control, renal function and medications (ultimately these data will be use to for cost-effectiveness analysis).

SCOTS will record gastric bypass, sleeve gastrectomy and laparoscopic gastric banding procedures. Whether the study will include other novel techniques will be considered for inclusion in the study by the steering committee once they are being performed in Scotand.

“One of the key factors which makes this study possible in Scotland is the excellent existing IT infrastructure which links across the NHS and will allow us to build an effective and economical clinical information system,” added Logue. “Clinical teams will record information on the surgery follow up weights. Patients will continue their normal face-to-face check-ups but through linkage to routinely collected health data, the SCOTS system will automatically track each of their contacts with the NHS, allowing researchers regular updates with minimal inconvenience for patients.”

The final report from the study will be prepared in 2026, although a number of interim papers are planned that would report one-year postoperative complications (including mortality), two-year diabetes, quality of life and nutritional outcomes and  7.5 year outcomes (including mortality, CVD events, incident diabetes, diabetes outcomes and quality of life).

The study will include all 13 regional centres in Scotland where bariatric surgery is performed (as of January 2014, ten of the 13 sites are ready to begin recruiting patients).

"This project was funded by the NIHR Health Technology Assessment Programme (project number 10/42/02). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health."

For more information, please visit the SurgiCal Obesity Treatment Study (SCOTS) website

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