What groups of people are more prone to complications after Bariatric Surgery, and does acid suppression in the stomach play a role? A mulitregister study

ISRCTN ISRCTN12963684
DOI https://doi.org/10.1186/ISRCTN12963684
Secondary identifying numbers PPI-GBP 001
Submission date
20/09/2016
Registration date
04/11/2016
Last edited
21/04/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Since obesity (being very overweight) is a growing health problem all over the world, more and more people are having weight-loss surgery because of its proven effects on obesity and related health problems. Having an operation is never risk free, and although weight-loss surgery is relatively safe, there are certain groups of people who are more at risk for complications. Drugs reducing stomach acid are used with varying degrees of success for the purpose of reducing complications, but it’s not clear how great this effect is and who benefits from it. The purpose of this study is to identify groups of patients that are at higher risk for complications and who could benefit most from acid suppression in the stomach.

Who can participate?
Patients that had weight loss surgery (gastric bypass) in Sweden between 2009-2014 and registered in the Scandinavian Obesity Surgery Registry.

What does the study involve?
Data is taken from the Scandinavian Obesity Surgery Register (SOReg) for patients that have had first time gastric bypass surgeries from 2009 through 2014. In addition, matching socio-economic data (that is data describing a person’s age, gender and income for example) is taken from Statistics Sweden and records on proton-pump inhibition prescriptions from the National Board of Health and Welfare's Drug Registry. Analysis is then done on this data, to see whether what type of patient is least likely to develop complications after weight loss surgery.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
Department of Surgery and Orthopedics, Lycksele Hospital

When is the study starting and how long is it expected to run for?
October 2016 to May 2017

Who is funding the study?
1. County Council of Västerbotten (Sweden)
2. Umeå University (Sweden)

Who is the main contact?
1. Dr Jeff Wennerlund (public)
Jeff.Wenerlund@umu.se
2. Professor Ulf Gunnarsson (scientific)
Ulf.Gunnarsson@umu.se

Contact information

Dr Jeff Wennerlund
Public

Lycksele Hospital
Department of Surgery and Orthopedics
Lycksele
92182
Sweden

ORCiD logoORCID ID 0000-0003-0603-751X
Phone +46 70-438 1109
Email Jeff.Wennerlund@umu.se
Prof Ulf Gunnarsson
Scientific

Department of Surgical and Perioperative Sciences
Umeå Univerisity
Umeå
901 87
Sweden

Phone +46 90-7852909
Email Ulf.Gunnarsson@umu.se

Study information

Study designSingle-site observational cohort study
Primary study designObservational
Secondary study designCohort study
Study setting(s)Hospital
Study typePrevention
Scientific titleWhich sub-groups of people are more prone to complications after complications after Bariatric Surgery, and does post-operative prophylaxis with proton-pump inhibition play a role? A multiregister study
Study acronymPPI-GBP
Study objectivesWhich combinations of factors predispose to complications after gastric bypass surgery? Does prophylaxis with proton-pump inhibition play a role? What differernces can be acertained from gender, age, existing co-morbidity, BMI, and socio-economic factors? The underlying hypothesis is that certain factors play a role in complications, and if/where proton-pump inhibition has a place in the clinical setting.
Ethics approval(s)Regional Ethics Committee of Umeå 12/1/2016. Case number 2015/367-31
Health condition(s) or problem(s) studiedMorbid obesity
InterventionPatient specific gender, age, BMI, existing co-morbidities, socio-economic status, and the presence of proton-pump inhibition is to be collected and compared with the occurrence of post-operative complications in a longitudinal multi-variate study .

After collecting data from the three registers, statistical analyses will be made focusing on the outcome of post-operative complications and their severity (according to the Clavien-Dindo scale) and necessary interventions, if any. Logistic regression models will be used in multi-variate analyses to pinpoint those factors (patient specific age, gender, BMI, pre-existing health problems, occurrence of proton-pump inhibition prophylaxis, and socioeconomic factors) that are associated with higher rates of complications, both as a total rate and for each individual complication. The rate of complications are also controlled against the Drug Registry if the prophylaxis was actually retrieved, or if therapy was prescribed and retrieved for other reasons.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Omeprazole, esomprazole
Primary outcome measureIdentification of sub-groups according to age, gender, body mass index measured in body weight (kg)/ body length (m) squared, and pre-existing health problems at baseline that have less post-operative complications and severity thereof (according to the Clavien-Dindo scale) due to prophylaxis with proton-pump inhibition, measured at 30 days and at 1 and 2 years post-operatively.
Secondary outcome measuresIdentification of socioeconomic factors at baseline that impact related health problems, the rate of post-operative complications, and occurrence and adherence to proton-pump prophylaxis.
Overall study start date31/10/2016
Completion date31/05/2017

Eligibility

Participant type(s)Patient
Age groupAll
SexBoth
Target number of participantsca 39,000
Total final enrolment37301
Key inclusion criteriaPatients eligible and accepted for primary laparoscopic gastric bypass surgery in Sweden during 2009-2014, and registered in the Scandinavian Obesity Surgery Registry (SOReg).
Key exclusion criteriaParticipants that do not fulfill inclusion criteria
Date of first enrolment31/10/2016
Date of final enrolment31/01/2017

Locations

Countries of recruitment

  • Sweden

Study participating centre

Department of Surgery and Orthopedics, Lycksele Hospital
Hedlundavägen
Lycksele lasarett
Lycksele
92182
Sweden

Sponsor information

County Council of Västerbotten (Västerbottens läns landsting)
Government

Köksvägen 11
Umeå
901 89
Sweden

Phone +46 90-785 0000
Email landstinget@vll.se
Website www.vll.se
ROR logo "ROR" https://ror.org/04xvhsp09

Funders

Funder type

University/education

County Council of Västerbotten (Västerbottens läns landsting)

No information available

Umeå Universitet
Government organisation / Universities (academic only)
Alternative name(s)
Umeå University, Ubmeje universitiähta, Universitas Umensis
Location
Sweden

Results and Publications

Intention to publish date18/01/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planThe results are to be published in a peer-review scientific journal. The results will be presented within the local research network, and at national and international scientific conferences.
IPD sharing planCollecting data from these registers is done under certain conditions. These include that the data may not be shared with a third party, is to be used only according to the purpose stated in the applications and the signed contracts, and that the data is to be erased after the project is completed. Further the information is to be handled in the same manner as patient charts, with utmost confidentiality, with identifying information separate from the raw data and calculation files.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/05/2020 21/04/2020 Yes No

Editorial Notes

21/04/2020: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.
19/11/2019: The intention to publish date was changed from 12/05/2019 to 18/01/2020.
01/11/2019: Internal review.
12/03/2019: The intention to publish date was changed from 28/02/2018 to 12/05/2019.
23/10/2017: The intention to publish date was changed from 30/04/2017 to 28/02/2018.