Bariatric surgery and fracture risk
Patients who have bariatric surgery may face an elevated risk of bone fractures, according to a Swedish study investigating the association between different bariatric surgery procedures and fracture risk. The paper, ‘Fracture risk after three bariatric surgery procedures in Swedish obese subjects: up to 26 years follow‐up of a controlled intervention study’, published in the Journal of Internal Medicine
The study included 2,007 Swedish patients with obesity who had bariatric (13.3% gastric bypass, 18.7% gastric banding and 68.0% vertical banded gastroplasty)) and 2,040 matched patients who did not undergo surgery. Over a median follow-up of between 15 and 18 years for the different treatment groups, the highest incidence rate for fractures was seen in the gastric bypass group. Rates were 22.9 per 1,000 person-years in this group, compared with 10.4, 10.7, and 9.3 per 1,000 person-years for the vertical banded gastroplasty, gastric banding, and control groups, respectively (all p<0.001). These rates translate to 229, 104, 107 and 93 people experiencing a fracture per 10,000 people over one year.
The fracture risk in the gastric bypass group was 2.58-times higher than in the control group, 1.99-times higher than in the gastric banding group, and 2.15-times higher than in the vertical banded gastroplasty group.
"Our results show that gastric bypass surgery increases the long-term risk of fracture, both compared with non-surgical obesity care and compared two other bariatric surgery methods used in our study," said lead author, Dr Sofie Ahlin of the University of Gothenburg, in Sweden. "Increased risk of fracture is a serious side effect that should be taken into account when selecting surgical procedures and it should also be kept in mind during post-operative follow-up in patients who have undergone gastric bypass."