Evidence map›Paper›PMID 32507657›Full record

ArticleSurgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery2020

Long-term opioid use after bariatric surgery.

Matthew L Maciejewski, Valerie A Smith, Theodore S Z Berkowitz, David E Arterburn, Katharine A Bradley, Maren K Olsen, Chuan-Fen Liu, Edward H Livingston, Luke M Funk, James E Mitchell

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
3.5field-weighted citation impact, top 7% 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

12 citing papers in PubMed, 23 citations in OpenAlex.

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  12. Letter to the Editor.Obesity surgery · 2021
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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

10 authors at 6 institutions in 1 country.

Matthew L MaciejewskiCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina; Department of Population Health Sciences, Duke University, Durham, North Carolina; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina. Electronic address: matthew.maciejewski@va.gov.
Valerie A SmithCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina; Department of Population Health Sciences, Duke University, Durham, North Carolina; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina.
Theodore S Z BerkowitzCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina.
David E ArterburnKaiser Permanente Washington Health Research Institute, Seattle, Washington; Department of Medicine, University of Washington, Seattle, Washington.
Katharine A BradleyKaiser Permanente Washington Health Research Institute, Seattle, Washington; Department of Medicine, University of Washington, Seattle, Washington; Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Healthcare System, Seattle, Washington; Department of Health Services, University of Washington, Seattle, Washington.
Maren K OlsenCenter of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina.
Chuan-Fen LiuDepartment of Health Services, University of Washington, Seattle, Washington.
Edward H LivingstonVeterans Administration North Texas Healthcare System, Dallas, Texas; Department of Surgery, University of California at Los Angeles, Los Angeles, California; Division of General Surgery, Northwestern University, Evanston, Illinois; Journal of the American Medical Association, Chicago, Illinois.
Luke M FunkDepartment of Surgery, Wisconsin Surgical Outcomes Research Program, University of Wisconsin-Madison, Madison, Wisconsin; William S. Middleton Veterans Memorial Hospital, Madison, Wisconsin.
James E MitchellUniversity of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
Durham VA Medical Center · USKaiser Permanente Washington Health Research Institute · USUniversity of North Dakota · USUniversity of Washington · USUniversity of Wisconsin–Madison · USVA North Texas Health Care System · US

Funding

Long-term Mental Health Outcomes of Bariatric SurgeryR01DA040056 · NIDA · DUKE UNIVERSITY · PI MACIEJEWSKI, MATTHEW L · 2016 to 2020
$2.3M
Impact of Financing on Outcomes of Methadone MaintenanceR01DA015060 · NIDA · RMC RESEARCH CORPORATION · PI DECK, DENNIS D · 2002 to 2004
$1.4M
HSR&D Senior Research Career Scientist AwardIK6HX003157 · VA · DURHAM VA MEDICAL CENTER · PI MATTHEW L MACIEJEWSKI · 2020 to 2026
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HSRD VA IK6 HX003157NIDA NIH HHS R01 DA015060NIDA NIH HHS R01 DA040056
6 · The paper itself

Abstract

backgroundOpioid analgesics are often prescribed to manage pain after bariatric surgery, which may develop into chronic prescription opioid use (CPOU) in opioid-naïve patients. Bariatric surgery may affect opioid use in those with or without presurgical CPOU.

objectiveTo compare CPOU persistence and incidence in a large multisite cohort of veterans undergoing bariatric surgery (open Roux-en-Y gastric bypass, laparoscopic RYGB, or laparoscopic sleeve gastrectomy) and matched nonsurgical controls.

settingVeterans Administration hospitals.

methodsIn a retrospective cohort study, we matched 1117 surgical patients with baseline CPOU to 9531 nonsurgical controls, and 2822 surgical patients without CPOU at baseline to 26,392 nonsurgical controls using sequential stratification. CPOU persistence in veterans with baseline CPOU was estimated using generalized estimating equations by procedure type. CPOU incidence in veterans without baseline CPOU was estimated in Cox regression models by procedure type because postoperative pain, complications, and absorption may differ by procedure.

resultsIn veterans with baseline CPOU, postsurgical CPOU declined over time for each surgical procedure; these trends did not differ between surgical patients and nonsurgical controls. In veterans without baseline CPOU, compared with nonsurgical controls, bariatric patients had higher CPOU incidence within 5 years after open Roux-en-Y gastric bypass (hazard ratio = 1.19; 95% confidence interval: 1.06-1.34) or laparoscopic open Roux-en-Y gastric bypass (hazard ratio = 1.22, 95% confidence interval: 1.06-1.41). Veterans undergoing laparoscopic sleeve gastrectomy had higher CPOU incidence 1 to 5 years after surgery (hazard ratio = 1.28; 95% confidence interval: 1.05-1.56) than nonsurgical controls.

conclusionsBariatric surgery was associated with greater risk of CPOU incidence in patients without baseline CPOU but was not associated with greater CPOU persistence.

Indexed as

Bariatric SurgeryGastric BypassLaparoscopyObesity, MorbidAnalgesics, OpioidGastrectomyHumansRetrospective StudiesWeight LossAnalgesics, OpioidBariatricGastric bypassMatchingMedicationObesityOpioidSleeve gastrectomySurgeryVeterans

Identifiers

PMID32507657
PMCPMC7423624
OpenAlexW3023001213

What OpenQuestion holds

Textmetadata
LicenceTDM
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.