Evidence map›Paper›PMID 33398584›Full record

ArticleSurgical endoscopy2021

Access to bariatric surgery among older patients in a publicly funded regionalized care system.

Ahmad I Elnahas, Aristithes G Doumouras, Mehran Anvari, Christopher M Schlachta, Andrew McClure, Nawar A Alkhamesi, Jeffrey D Hawel, David R Urbach

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 34% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Bariatric surgery and menopause.Przeglad menopauzalny = Menopause review · 2022
    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

8 authors at 3 institutions in 1 country.

Ahmad I ElnahasDepartment of Surgery, Western University, 339 Windermere Road, London, ON, N6A 5A5, Canada. ahmad.elnahas@lhsc.on.ca.ORCID 0000-0001-5910-5374
Aristithes G DoumourasInstitute for Clinical Evaluative Sciences, London, ON, Canada.
Mehran AnvariInstitute for Clinical Evaluative Sciences, London, ON, Canada.
Christopher M SchlachtaDepartment of Surgery, Western University, 339 Windermere Road, London, ON, N6A 5A5, Canada.
Andrew McClureInstitute for Clinical Evaluative Sciences, London, ON, Canada.
Nawar A AlkhamesiDepartment of Surgery, Western University, 339 Windermere Road, London, ON, N6A 5A5, Canada.
Jeffrey D HawelDepartment of Surgery, Western University, 339 Windermere Road, London, ON, N6A 5A5, Canada.
David R UrbachInstitute for Clinical Evaluative Sciences, London, ON, Canada.
Western University · CAInstitute for Clinical Evaluative Sciences · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBariatric surgery in older patients is safe and effective. Current guidelines do not endorse age limits for surgery; however, older patients may encounter difficulties with access given perceived risks. This study compares the adjusted probability of failing to receive bariatric surgery between older (≥ 60 years) and younger (< 60 years) patients referred to a publicly funded program. STUDY

designThis is a retrospective cohort study of adult patients referred to a bariatric surgery program in Ontario from 2010-2016. Ontario health administrative databases and the Ontario Bariatric Registry were used for the analysis. The primary outcome was receipt of bariatric surgery within 3 years of referral. A multivariable logistic regression analysis was performed to determine the adjusted effect of older age (≥ 60 years) on the probability of not receiving surgery. Sensitivity analysis was performed using only healthy patients.

resultsAmong 19,510 patients referred to the program, 1,795 patients (9.2%) were ≥ 60 years old, of which 60% received bariatric surgery within 3 years compared to 90% in younger patients. The odds older patients do not receive surgery after adjustment were significantly higher compared to younger patients (OR 1.69 [1.52-1.88], P < .001). This effect persists even among a subgroup of older patients with a Charlson Comorbidity Index = 0 (OR 1.78 [1.56-2.04], P < .001).

conclusionsAge alone, rather than comorbidities had a more significant effect on the access to bariatric surgery in older patients. Given the demonstrated benefits of bariatric surgery in older populations, ensuring equity in access to bariatric surgery should be encouraged. Future research is required to explore the underlying reasons why older patients who could benefit from bariatric surgery may not have the opportunity.

Indexed as

Bariatric SurgeryObesity, MorbidAdultAgedComorbidityHumansMiddle AgedReferral and ConsultationRetrospective StudiesAccessAgedBariatricElderly

Identifiers

PMID33398584
OpenAlexW3118491346

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.