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Bariatric Surgery Decreases the Risk of Non-traffic Accident–Related Fractures in Patients with Obesity: Real-world Data from Taiwan

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Abstract

Objectives

The aim of this study is to investigate the impact of bariatric surgery on non-traffic accident–related fractures in patients with obesity.

Methods

This retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database. Patients aged 18 to 55 years with obesity diagnosis between 2003 and 2008 were enrolled and divided into two groups: non-surgical and bariatric surgery groups. Patients with endocrine bone disease and malignancy history were excluded. Healthy patients were also randomly selected from the database and assigned to the general population group. The development of fracture was the primary end point. All patients were followed until the end of 2013 or death, whichever came first.

Results

After propensity score matching, 1322, 1322, and 4359 subjects were included in the bariatric surgery (BS), non-surgical (NS), and general population (GP) groups, respectively. Based on multivariate analysis, the risk of overall fractures is similar between the BS group (hazard ratio [HR] = 0.774, p = 0.164) and the NS group; nevertheless, the risk of overall fractures was higher in the BS group (HR = 2.210, p<0.001) than in the GP group. The BS group had a significantly lower risk of non-traffic accident–related fractures (HR = 0.542, p = 0.010) than the NS group but a higher risk of non-traffic accident–related fractures (HR = 1.693, p = 0.023) than the GP group.

Conclusions

Bariatric surgery may decrease the risk of non-traffic accident–related fractures; however, the risk remains higher in patients with obesity than in the general population.

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Acknowledgements

This study is based in part on data from the National Health Insurance Research Database (NHIRD), provided by the National Health Insurance Administration, Ministry of Health and Welfare and managed by the National Health Research Institutes (registered number NHIRD-103-246). The data utilized in this study cannot be made available in the manuscript, the supplemental files, or in a public repository due to the “Personal Information Protection Act” executed by Taiwan’s government, starting from 2012. Requests for data can be sent as a formal proposal to the NHIRD (http://nhird.nhri.org.tw) or by email to nhird@nhri.org.tw.

Funding

This work was supported by the E-da Hospital Research Foundation ( EDAHI-109-001, EDAHI-110-003) and E-da Cancer Hospital Research Foundation ( EDCHP-107-007).

Author information

Author notes

  1. Po-Jui Chi contributed equally as corresponding author.

Authors and Affiliations

  1. Bariatric and Metabolic Surgery Center, E-Da Hospital, Kaohsiung, Taiwan

    Wei Leng Chin, Chung-Yen Chen & Jian-Han Chen

  2. Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan

    Wei Leng Chin, Wei-Chieh Hung & Chi-Wei Lin

  3. Department of Family Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan

    Wei Leng Chin

  4. Devision of Nephorology, E-Da Hospital, Kaohsiung, Taiwan

    Po-Jui Chi

  5. Department of General Surgery, E-Da Hospital, Kaohsiung, Taiwan

    Chung-Yen Chen & Jian-Han Chen

  6. School of Medicine College of medicine, I-Shou University, Kaohsiung, Taiwan

    Wei Leng Chin, Po-Jui Chi, Wei-Chieh Hung, Chi-Wei Lin, Chung-Yen Chen & Jian-Han Chen

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Contributions

WLC, PJC, WCH and JHC contributed to the study design and wrote the manuscript; WCH and CWL contributed to the statistical analysis; WLC and CYC, contributed to the manuscript’s preparation and editing; JHC and PJC contributed to the study design, statistical analyses, supervising the work, and manuscript preparation. PJC and JHC are the guarantors of the content of the manuscript. All authors have seen and approved the manuscript.

Corresponding author

Correspondence to Jian-Han Chen.

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Ethical Approval

All procedures performed in studies involving human participants were following the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study is based in part on data from the National Health Insurance Research Database (NHIRD), provided by the National Health Insurance Administration, Ministry of Health and Welfare and managed by the National Health Research Institutes (registered number NHIRD-103-246). The data utilized in this study cannot be made available in the manuscript, the supplemental files, or in a public repository due to the “Personal Information Protection Act” executed by Taiwan’s government, starting from 2012. Requests for data can be sent as a formal proposal to the NHIRD (http://nhird.nhri.org.tw) or by email to nhird@nhri.org.tw. The present study was thoroughly evaluated and approved by the Institutional Review Board of E-Da Hospital (approval EMRP-106-063).

Informed Consent

For this type of study, formal consent is not required.

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The authors declare that they have no conflict of interest.

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Chin, W.L., Chi, PJ., Hung, WC. et al. Bariatric Surgery Decreases the Risk of Non-traffic Accident–Related Fractures in Patients with Obesity: Real-world Data from Taiwan. OBES SURG 31, 2231–2240 (2021). https://doi.org/10.1007/s11695-021-05262-8

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  • DOI: https://doi.org/10.1007/s11695-021-05262-8

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