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Bariatric Surgery

Long-term incidence of serious fall-related injuries after bariatric surgery in Swedish obese subjects

International Journal of Obesity volume 43, pages 933–937 (2019)Cite this article

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Abstract

Obesity increases risk of falling, but the effect of bariatric surgery on fall-related injuries is unknown. The aim of this study was therefore to study the association between bariatric surgery and long-term incidence of fall-related injuries in the prospective, controlled Swedish Obese Subjects study. At inclusion, body mass index was ≥ 34 kg/m2 in men and ≥38 kg/m2 in women. The surgery per-protocol group (n = 2007) underwent gastric bypass (n = 266), banding (n = 376), or vertical banded gastroplasty (n = 1365), and controls (n = 2040) received usual care. At the time of analysis (31 December 2013), median follow-up was 19 years (maximal 26 years). Fall-related injuries requiring hospital treatment were captured using data from the Swedish National Patient Register. During follow-up, there were 617 first-time fall-related injuries in the surgery group and 513 in the control group (adjusted hazard ratio 1.21, 95% CI, 1.07–1.36; P = 0.002). The incidence differed between treatment groups (P < 0.001, log-rank test) and was higher after gastric bypass than after usual care, banding and vertical banded gastroplasty (adjusted hazard ratio 0.50–0.52, P < 0.001 for all three comparisons). In conclusion, gastric bypass surgery was associated with increased risk of serious fall-related injury requiring hospital treatment.

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Acknowledgements

We thank the staff members at 480 primary health-care centers and 25 surgical departments in Sweden that participated in the study. We acknowledge Gerd Bergmark, Christina Torefalk, and Björn Henning for invaluable administrative support and Rosie Perkins for editing the manuscript.

Author contibutions

Study concept and design: LMSC, KS, PAS, MP. Acquisition, analysis, or interpretation of data: LMSC, KS, SA, PJ, JCAA, LKL, CM, CK, SH, MT, PAS, BC, MP. Drafting of the manuscript: LMSC, KS, MP. Critical revision of the manuscript for important intellectual content: SA, PJ, JCAA, LKL, CM, CK, SH, MT, BC, PAS. Statistical analysis: MP. Obtained funding: LMSC, KS, SA, CM. Technical or material support: LMSC, KS, SA, PJ, JCAA, LKL, CM, CK, SH, MT, PAS, BC, MP. Study supervision: LMSC, MP. KS had full access to the data in the study and final responsibility for the decision to submit for publication.

Funding

Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number R01DK105948. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Authors of this study were also supported by the Swedish Research Council (K2013-54x-11285-19 and 2016-00522), Västra Götaland Region ALF research grants and the Swedish Diabetes Foundation. The Wallenberg Centre for molecular and translational medicine (C.M.) is partly funded by AstraZeneca. The funders had no role in the interpretation of these data or in the writing of this article.

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Authors and Affiliations

  1. Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    Lena M. S. Carlsson, Kajsa Sjöholm, Sofie Ahlin, Peter Jacobson, Johanna C. Andersson-Assarsson, Linda Karlsson Lindahl, Cristina Maglio, Cecilia Karlsson, Stephan Hjorth, Magdalena Taube, Björn Carlsson & Per-Arne Svensson

  2. Catholic University of the Sacred Heart, Rome, Italy

    Sofie Ahlin

  3. Wallenberg Centre for molecular and translational medicine, University of Gothenburg, Gothenburg, Sweden

    Cristina Maglio

  4. Global Medicines Development, AstraZeneca Gothenburg, Mölndal, Sweden

    Cecilia Karlsson

  5. CVMD Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca Gothenburg, Mölndal, Sweden

    Björn Carlsson

  6. Institute of Health and Care Sciences, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    Per-Arne Svensson

  7. National Institute for Health and Welfare, Helsinki, Finland

    Markku Peltonen

Authors
  1. Lena M. S. Carlsson
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  2. Kajsa Sjöholm
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  11. Björn Carlsson
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  13. Markku Peltonen
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Corresponding author

Correspondence to Kajsa Sjöholm.

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Conflict of interest

LMSC has obtained lecture fees from AstraZeneca, Johnson&Johnson, and MSD. BC and CK are employed by AstraZeneca and hold stocks in the same company. SH holds stocks in AstraZeneca. MT holds stocks in Umecrine AB, and has a patent licensed to Umecrine AB. No other conflict of interest relevant to this study was reported.

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41366_2018_97_MOESM1_ESM.docx

SUPPLEMENTARY APPENDIX to Long-term incidence of serious fall-related injuries after bariatric surgery in Swedish Obese Subjects

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Carlsson, L.M.S., Sjöholm, K., Ahlin, S. et al. Long-term incidence of serious fall-related injuries after bariatric surgery in Swedish obese subjects. Int J Obes 43, 933–937 (2019). https://doi.org/10.1038/s41366-018-0097-y

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