Table 2.
Meta-analyses of surgery risk and comorbidities remission outcomes: means and 95% credible intervals are in brackets
| GB | AGB | SG | Control | Overall | ||
|---|---|---|---|---|---|---|
| Mortality ≤ 30 days | ||||||
| RCT | Estimates (%) | 0.08 [0.01, 0.30] | 0.11 [0.01, 0.50] | 0.50 [0.01, 3.88] | -- [--, --] | 0.08 [0.01, 0.24] |
| Study/arm/patient # | 11/18/934 | 5/8/743 | 1/2/40 | 0/0/0 | 15/30/1,803 | |
| OBS | Estimates (%) | 0.38 [0.22, 0.59] | 0.07 [0.02, 0.12] | 0.29 [0.11, 0.63] | -- [--, --] | 0.22 [0.14, 0.31] |
| Study/arm/patient # | 19/30/90,090 | 26/29/40,538 | 10/11/3,647 | 1/1/9 | 48/79/136,903 | |
| Mortality > 30 days | ||||||
| RCT | Estimates (%) | 0.39 [0.01,0.86] | 0.14 [0.00, 0.55] | 6.00 [0.00, 100.00] | -- [--, --] | 0.31 [0.01, 0.75] |
| Study/arm/patient # | 11/19/954 | 5/7/613 | 2/2/40 | 0/0/0 | 15/30/1,703 | |
| OBS | Estimates (%) | 0.72 [0.28, 1.30] | 0.21 [0.08, 0.37] | 0.34 [0.14, 0.60] | -- [--, --] | 0.35 [0.20, 0.52] |
| Study/arm/patient # | 13/18/29,256 | 18/22/33,950 | 8/9/3,099 | 0/0/0 | 32/51/66,897 | |
| Complication rates | ||||||
| RCT | Estimates (%) | 21.00 [12.00, 33.00] | 13.00 [5.20, 26.00] | 13.00 [0.70, 44.00] | -- [--, --] | 17.00 [11.00, 23.00] |
| Study/arm/patient # | 10/14/649 | 7/11/855 | 2/2/137 | 2/2/59 | 16/30/1,778 | |
| OBS | Estimates (%) | 12.00 [7.30, 17.00] | 7.80 [3.90, 13.00] | 8.90 [5.60, 13.00] | -- [--, --] | 9.80 [7.40, 13.00] |
| Study/arm/patient # | 19/28/71,020 | 22/24/36,778 | 8/20/4,987 | 0/0/0 | 48/74/113,002 | |
| Reoperation rates | ||||||
| RCT | Estimates (%) | 2.56 [0.61, 5.36] | 12.23 [4.46, 24.46] | 9.05 [0.77, 34.56] | -- [--, --] | 6.95 [3.27, 12.04] |
| Study/arm/patient # | 6/8/512 | 8/10/502 | 2/2/161 | 0/0/0 | 12/23/1,322 | |
| OBS | Estimates (%) | 5.34 [4.48, 6.48] | 7.01 [3.99, 11.24] | 2.96 [1.70, 4.71] | -- [--, --] | 5.75 [4.05, 7.83] |
| Study/arm/patient # | 6/8/23,688 | 18/21/30,314 | 7/7/2,912 | 0/0/0 | 25/39/57,171 | |
| Diabetes remission rates | ||||||
| RCT | Estimates (%) | 95.15 [88.38, 98.80] | 73.88 [36.06, 96.18] | -- [--, --] | 17.64 [0.98, 69.27] | 91.99 [84.68, 97.18] |
| Study/arm/patient # | 6/10/152 | 2/2/35 | 0/0/0 | 1/1/30 | 8/14/206 | |
| OBS | Estimates (%) | 92.83 [85.29, 97.21] | 67.58 [49.51, 82.83] | 85.53 [72.69, 94.07] | -- [--, --] | 86.05 [78.74, 91.62] |
| Study/arm/patient # | 16/22/5,924 | 18/19/2,509 | 14/15/597 | 0/0/0 | 43/57/9,037 | |
| Hypertension remission rates | ||||||
| RCT | Estimates (%) | 80.98 [68.21, 91.52] | 53.55 [12.52, 89.63] | -- [--, --] | 49.00 [0.00, 99.00] | 75.18 [61.52, 86.35] |
| Study/arm/patient # | 6/11/183 | 2/2/27 | 0/0/0 | 1/1/27 | 8/15/243 | |
| OBS | Estimates (%) | 78.13 [63.67, 88.76] | 63.73 [51.74, 75.43] | 82.23 [68.19, 92.01] | 15.00 [1.40, 53.00] | 74.36 [66.53, 81.19] |
| Study/arm/patient # | 11/15/9,586 | 18/19/6,214 | 11/12/1,152 | 2/2/82 | 37/47/16,962 | |
| Dyslipidemia remission rates | ||||||
| RCT | Estimates (%) | 80.16 [61.68, 94.19] | 39.95 [4.69, 87.05] | -- [--, --] | -- [--, --] | 75.77 [55.63, 91.49] |
| Study/arm/patient # | 5/8/147 | 1/1/132 | 0/0/0 | 0/0/0 | 5/9/279 | |
| OBS | Estimates (%) | 63.22 [40.86, 82.34] | 60.91 [49.45, 72.36] | 82.86 [62.67, 94.55] | 5.42 [0.12, 30.41] | 67.93 [58.08, 77.01] |
| Study/arm/patient # | 5/7/556 | 11/11/351 | 5/5/570 | 1/1/63 | 20/23/1,477 | |
| Cardiovascular disease remission rates | ||||||
| RCT | Estimates (%) | -- [--, --] | -- [--, --] | -- [--, --] | -- [--, --] | 65.81 [6.21, 99.46] |
| Study/arm/patient # | 0/0/0 | 0/0/0 | 0/0/0 | 0/0/0 | 1/1/3 | |
| OBS | Estimates (%) | 22.00 [0.00, 100.00] | 78.00 [0.00, 100.00] | -- [--, --] | -- [--, --] | 58.00 [0.00, 100.00] |
| Study/arm/patient # | 1/1/17 | 2/2/10 | 0/0/0 | 0/0/0 | 3/3/27 | |
| Sleep apnea remission rates | ||||||
| RCT | Estimates (%) | 95.41 [84.49, 99.79] | 94.26 [49.43, 100.00] | -- [--, --] | -- [--, --] | 96.16 [86.66, 99.80] |
| Study/arm/patient # | 3/6/41 | 2/2/2 | 0/0/0 | 0/0/0 | 5/9/44 | |
| OBS | Estimates (%) | 94.68 [86.36, 98.72] | 71.14 [48.29, 89.16] | 90.77 [80.06, 97.39] | -- [--, --] | 89.53 [81.33, 95.08] |
| Study/arm/patient # | 8/11/5,748 | 13/14/3,598 | 8/9/498 | 0/0/0 | 27/35/9,845 | |
Estimates were computed using Bayesian random-effects meta-analysis. Arms refer to subgroups within studies receiving different surgical procedures. GB: gastric bypass; AGB: adjustable gastric banding; SG: sleeve gastrectomy; Control: non-surgical interventions (non-surgical interventions were included in the analyses only when they were compared with surgical interventions); Overall: all surgery except for Control; RCT: randomized controlled trials; OBS: observational studies; --: estimates are not available when 0/0/0 (no data were included in the analysis) are presented or not relevant. Remission rate is defined as the proportion of the surgery patients who reported the target comorbid condition being either resolved or improved after surgery.