By pass y fractura

Fracture Risk Higher After Gastric Bypass Than Gastric Banding

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Roux-en-Y gastric bypass carries a higher fracture risk than adjustable gastric banding, according to a retrospective study in JAMA Surgery.

Researchers examined Medicare claims data on nearly 30,000 adults who underwent gastric bypass and 13,000 who had gastric banding. During 3–4 years' follow-up, the incidence of any nonvertebral fracture was 6.6 per 1000 person-years with bypass versus 4.6 per 1000 with banding. After multivariable adjustment, bypass was associated with a 73% increased risk.

Gastric bypass conferred significantly increased fracture risks at the hip, wrist, and pelvis, with the greatest risk increase seen for hip fracture (hazard ratio, 2.8).

The researchers note that gastric bypass "is associated with high-turnover bone loss with significant, long-term declines in bone density and deterioration of microarchitecture." Commentators, meanwhile, question the clinical significance of the findings given the low absolute risks — for example, only 0.4% of bypass patients and 0.2% of banding patients had hip fractures.

JAMA Surgery article (Free abstract)

JAMA Surgery commentary (Subscription required)

Background: Physician's First Watch coverage of guidelines on post-bariatric surgery care (Free)

Sent from my iPhone

Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

Please excuse the shortness of this message, as it has been sent from
a mobile device.