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Clinical Characteristics of Roux-en-Y Gastric Bypass Patients with Death from Accidental Overdose or Intentional Self-Harm: a Descriptive Study

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Abstract

Purpose

The objective of this descriptive study was to identify clinical characteristics of Roux-en-Y gastric bypass (RYGB) patients who died from intentional self-harm or accidental overdose postoperatively.

Materials and Methods

This retrospective, descriptive study included RYGB patients from a large rural medical center that completed surgery between January 2004 and December 2014 and died from intentional self-harm or accidental overdose through December 2015. Specific causes of death were obtained from the National Death Index and clinical data from electronic health records. Clinical characteristics explored were age, sex, time to surgery, weight loss expectations, postoperative weight loss, medication, diagnoses, psychiatric histories (diagnoses, self-harm, suicidal ideation and behaviors, medications, substance use, preoperative Beck Depression Inventory-II scores), pain, social support, and reported life stressors.

Results

Overall, 22 patients of 146 total deceased patients died from intention self-harm (n = 6) or accidental overdose (n = 16) over the study period (77.3% female, mean age at time of surgery = 38.4 ± 9.1 years). Younger age (< 40 years), history of self-harm or depression, preoperative pain, and use of opioids at the time of surgery emerged as common characteristics in weight loss surgery patients who died from intentional self-harm or accidental overdose. No trends regarding social support, life stressors, or actual or expected weight loss were identified.

Conclusion

Certain weight loss surgery patients may be at risk for death from self-harm or overdose and may benefit from greater surveillance postoperatively.

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Funding

Research reported in this study was supported by the BLINDED under National Institutes of Health award #BLINDED.

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Authors and Affiliations

  1. Department of Psychology, Philadelphia College of Osteopathic Medicine (PCOM), 4190 City Avenue, Philadelphia, PA, 19131, USA

    Michelle R. Lent, Elizabeth Avakoff, Nicholas Hope & David S. Festinger

  2. Geisinger Clinic, Obesity Institute, 100 N. Academy Avenue, Danville, PA, 17822, USA

    Michelle R. Lent, Christopher D. Still, Adam M. Cook, Anthony T. Petrick, Peter N. Benotti & G. Craig Wood

Authors
  1. Michelle R. Lent
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  2. Elizabeth Avakoff
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  3. Nicholas Hope
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  4. David S. Festinger
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  5. Christopher D. Still
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  6. Adam M. Cook
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  7. Anthony T. Petrick
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  8. Peter N. Benotti
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  9. G. Craig Wood
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Corresponding author

Correspondence to Michelle R. Lent.

Ethics declarations

This study was approved by the health system’s Institutional Review Board.

Conflict of Interest

Author 1 received a research grant from the BLINDED. All other authors declare that they have no conflict of interest.

Statement of Human Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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

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Lent, M.R., Avakoff, E., Hope, N. et al. Clinical Characteristics of Roux-en-Y Gastric Bypass Patients with Death from Accidental Overdose or Intentional Self-Harm: a Descriptive Study. OBES SURG 28, 3531–3537 (2018). https://doi.org/10.1007/s11695-018-3379-5

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  • DOI: https://doi.org/10.1007/s11695-018-3379-5

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