ArticleSurgical endoscopy2018
Bariatric surgery increases risk of bone fracture.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Racial disparities in selected micronutrient deficiencies after bariatric surgery: A systematic review.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2024Pooled it
- Fracture risk following bariatric surgery: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Pooled it
- Smoking in bariatric surgery: a systematic review.Surgical endoscopy · 2021Pooled it
- Pooled it
- Bariatric Surgery Decreases the Risk of Non-traffic Accident-Related Fractures in Patients with Obesity: Real-world Data from Taiwan.Obesity surgery · 2021Trial
- Bone Mineral Density and Turnover After Sleeve Gastrectomy and Gastric Bypass: A Randomized Controlled Trial (Oseberg).The Journal of clinical endocrinology and metabolism · 2021Trial
- Trial
- Beyond Weight Loss: Skeletal Considerations in Obesity Treatment.Endocrinology and metabolism (Seoul, Korea) · 2026Review
- Bone Health and Anti-Osteoporotic Medication Eligibility in Postmenopausal Women Undergoing Bariatric Surgery: The Impact of Age and Modifiable Risk Factors.Calcified tissue international · 2026Observational
- Impact of Bariatric Surgery on Postoperative Outcomes, Complications, and Revision Rates in Total Knee Arthroplasty: A Big Data Analysis.Journal of clinical medicine · 2025Article
- Effects of Pregnancy and Lactation on Bone Microstructure and Material Properties in a Rat Model of Bariatric Surgery.Calcified tissue international · 2025Article
- Obesity and Skeletal Fragility.The Journal of clinical endocrinology and metabolism · 2024Review
- Musculoskeletal effects of obesity and bariatric surgery - a narrative review.Archives of endocrinology and metabolism · 2022Review
- Cortical Bone Loss Following Gastric Bypass Surgery Is Not Primarily Endocortical.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Article
- Risk of fracture following gastric surgery for benign and malignant conditions: A study level pooled analysis of population-based cohort studies.Frontiers in oncology · 2022Article
- Bone Response to Weight Loss Following Bariatric Surgery.Frontiers in endocrinology · 2022Review
- Rates, Risks, and Time to Fracture in Patients Undergoing Laparoscopic Vertical Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021Article
- Long-term Bone Loss and Deterioration of Microarchitecture After Gastric Bypass in African American and Latina Women.The Journal of clinical endocrinology and metabolism · 2021Article
- Impact of sleeve gastrectomy on hip structural analysis in adolescents and young adults with obesity.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2020Article
- MANAGEMENT OF ENDOCRINE DISEASE: Bone complications of bariatric surgery: updates on sleeve gastrectomy, fractures, and interventions.European journal of endocrinology · 2020Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
introductionThe purpose of this study was to determine the long-term incidence of bone fracture after bariatric surgery, identify specific risk factors for fracture, and compare these data to baseline risk in a comorbidity-matched morbidly obese population. We hypothesize that, despite prior studies with conflicting results, bariatric surgery increases a patient's long-term risk of fracture.
methodsAll patients who underwent bariatric surgery at a single institution 1985-2015 were reviewed. Univariate analysis of patient demographic data including comorbidities, insurance payer status, procedure type, and BMI was performed. Multivariate logistic regression was used to identify independent predictors of fracture in this population. Finally, we identified a propensity-matched control group of morbidly obese patients from our institutional Clinical Data Repository in the same timeframe who did not undergo bariatric surgery to determine expected rate of fracture without bariatric surgery.
resultsA total of 3439 patients underwent bariatric surgery, with 220 (6.4%) patients experiencing a bone fracture at mean follow-up of 7.6 years. On multivariate logistic regression, independent predictors of increased fracture included tobacco use and Roux-en-Y gastric bypass while private insurance and race were protective (table). Additionally, 1:1 matching on all comorbidity and demographic factors identified 3880 patients (1940 surgical patients) with equal propensity to undergo bariatric surgery. Between the propensity-matched cohorts, patients who had a history of bariatric surgery were more than twice as likely to experience a fracture as those who did not (6.4 vs. 2.7%, p < 0.0001).
conclusionsThis study of bariatric surgery patients at our institution identified several independent predictors of postoperative fracture. Additionally, these long-term data demonstrate patients who had bariatric surgery are at a significantly increased risk of bone fracture compared to a propensity-matched control group. Future efforts need to focus on nutrient screening and risk modification to reduce the impact of this long-term complication.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.