Evidence map›Paper›PMID 30806914›Full record

ArticleObesity surgery2019

Clostridium difficile and Laparoscopic Bariatric Surgery: an Analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database.

ThucNhi T Dang, Jerry T Dang, Muhammad Moolla, Noah Switzer, Karen Madsen, Daniel W Birch, Shahzeer Karmali

Abstract read
PubMed Publisher
In one paragraph

Article in Obesity surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

ThucNhi T DangDivision of Gastroenterology, Department of Medicine, University of Alberta Hospital, University of Alberta, 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada. thucnhi@ualberta.ca.ORCID 0000-0001-5825-6322
Jerry T DangDepartment of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Muhammad MoollaFaculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Noah SwitzerDepartment of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Karen MadsenDivision of Gastroenterology, Department of Medicine, University of Alberta Hospital, University of Alberta, 8440 112 Street NW, Edmonton, AB, T6G 2B7, Canada.
Daniel W BirchDepartment of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Shahzeer KarmaliDepartment of Surgery, University of Alberta, Edmonton, Alberta, Canada.
University of Alberta · CAUniversity of Alberta Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity is associated with disturbances in the gut microbiota which is a risk factor for Clostridium difficile infection (CDI). Bariatric surgery can induce substantive changes to the gut microbiota which may affect the risk of developing CDI.

methodsThe Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program captures variables specific to bariatric surgery from 832 centers. Patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) in 2016 and 2017 were identified. Primary outcomes included the prevalence and predictors of CDI after bariatric surgery. A multivariable logistic regression model determined preoperative factors predictive of 30-day CDI.

resultsA total of 78,222 LRYGB and 222,968 LSG were included. The overall incidence of CDI was low with 0.13% developing CDI. Rates of CDI were two times higher after LRYGB compared to LSG (0.2 vs 0.1%, p < 0.001). Although CDI rates were low, CDI was associated with increased post-operative complications. Multivariable analysis identified chronic kidney disease (OR 2.37, 95%CI 1.09-5.15, p = 0.03) and history of venous thromboembolism (OR 2.06, 95%CI 1.29-3.29, p = 0.002) as being most predictive of developing CDI with more than a twofold increase in risk. Patients undergoing LRYGB had an increased risk of CDI compared to LSG (OR 1.65, 95%CI 1.31-2.09, p < 0.001). White race, female sex, and obstructive sleep apnea also increased risk of CDI.

conclusionsThe incidence of CDI following bariatric surgery is relatively low with LRYGB having a higher risk than LSG. Furthermore, CDI is associated with significant adverse outcomes post-operatively but had no increased risk of mortality.

Indexed as

Clostridioides difficileAccreditationAdultAgedClostridium InfectionsDatabases, FactualFemaleGastrectomyGastric BypassHumansIncidenceLogistic ModelsMaleMiddle AgedObesity, MorbidPostoperative ComplicationsBariatric surgeryClostridium difficile infectionRoux-en-Y gastric bypassSleeve gastrectomy

Identifiers

PMID30806914
OpenAlexW2917356385

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.