Bariatric Surgery in Children and Adolescents with Cognitive Impairment and/or Developmental Delay: Current Knowledge and Clinical Recommendations

Matheson, Brittany E.; Colborn, D. Kathleen; Bohon, Cara

doi:10.1007/s11695-019-04219-2

Cited by 11 publications

(4 citation statements)

References 81 publications

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“…All of these conditions exhibit many similarities, as both patients and their family members suffer from obesity and related comorbidities, which are often accompanied by a sedentary lifestyle[ 12 ]. In terms of cognition, similar cognitive levels within the family[ 18 ] determine the development of obesity and weight loss outcome of bariatric surgery. The combination of these factors results in weaker dietary and exercise maintenance abilities among patients with FAO[ 19 ] than in those with SO, possibly contributing to their mid-to-long-term postoperative weight regain.…”

Section: Discussionmentioning

confidence: 99%

Novel subtype of obesity influencing the outcomes of sleeve gastrectomy: Familial aggregation of obesity

Wang,

Qu,

et al. 2024

World J Gastroenterol

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BACKGROUND Differences in the preoperative characteristics and weight loss outcomes after sleeve gastrectomy (SG) between patients with familial aggregation of obesity (FAO) and patients with sporadic obesity (SO) have not been elucidated. AIM To explore the impact of SG on weight loss and the alleviation of obesity-related comorbidities in individuals with FAO. METHODS A total of 193 patients with obesity who underwent SG were selected. Patients with FAO/SO were matched 1:1 by propensity score matching and were categorized into 4 groups based on the number of first-degree relatives with obesity (1SO vs 1FAO, 2SO vs 2FAO). The baseline characteristics, weight loss outcomes, prevalence of obesity-related comorbidities and incidence of major surgery-related complications were compared between groups. RESULTS We defined FAO as the presence of two or more first-degree relatives with obesity. Patients with FAO did not initially show significant differences in baseline data, short-term postoperative weight loss, or obesity-related comorbidities when compared to patients with SO preoperatively. However, distinctions between the two groups became evident at the two-year mark, with statistically significant differences in both percentage of total weight loss (P = 0.006) and percentage of excess weight loss (P < 0.001). The FAO group exhibited weaker remission of type 2 diabetes mellitus (T2DM) (P = 0.031), hyperlipidemia (P = 0.012), and non-alcoholic fatty liver disease (NAFLD) (P = 0.003) as well as a lower incidence of acid reflux (P = 0.038). CONCLUSION FAO patients is associated with decreased mid-to-long-term weight loss outcomes; the alleviation of T2DM, hyperlipidemia and NAFLD; and decreased incidence of acid reflux postoperatively.

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Section: Discussionmentioning

confidence: 99%

Novel subtype of obesity influencing the outcomes of sleeve gastrectomy: Familial aggregation of obesity

Wang,

Qu,

et al. 2024

World J Gastroenterol

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“…This may indicate that transplant centers are unable or unwilling to provide the additional pretransplant and posttransplant resources that some adults with IDD may require. Previous studies have shown that preoperative preparation and education, as well as ongoing follow-up support, have improved outcomes of adults with IDD for other surgical procedures (ie, bariatric surgery) . This could also be a promising approach for adults with IDD who are seeking organ transplant, but further work is needed to evaluate the impacts of prolonged education and support on transplant outcomes in this population.…”

Section: Discussionmentioning

confidence: 99%

Comparing Kidney Transplant Rates and Outcomes Among Adults With and Without Intellectual and Developmental Disabilities

et al. 2023

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ImportanceImproving equity in organ transplant access for people with intellectual and developmental disabilities (IDD) is a topic of social discourse in mainstream media, state legislation, and national legislation. However, few studies have compared evaluation rates, transplant rates, and outcomes among adults with and without IDD.ObjectiveTo compare rates of kidney transplant and transplant-specific outcomes between propensity–score matched groups of adults with end-stage kidney disease (ESKD [also referred to as end-stage renal disease (ESRD)]) with and without co-occurring IDD.Design, Setting, and ParticipantsThis retrospective cohort study included all Medicare inpatient and outpatient standard analytical files from 2013 through 2020. A total of 1 413 655 adult Medicare beneficiaries with ESKD were identified. Propensity–score matching was used to balance cohorts based on age, sex, race, follow-up duration, and Charlson Comorbidity Index. The matched cohorts consisted of 21 384 adults with ESKD (10 692 of whom had IDD) and 1258 kidney transplant recipients (629 of whom had IDD). Data were analyzed between June 1, 2022, and August 1, 2022.ExposureIDD.Main Outcomes and MeasuresEvaluation for kidney transplant, receipt of kidney transplant, perioperative complications, readmission, mortality, graft rejection, and graft failure.ResultsOf the 21 384 propensity–score matched adults with ESKD, the median (IQR) age was 55 (43-65) years, 39.2% were male, 27.4% were Black, 64.1% were White, and 8.5% identified as another race or ethnicity. After propensity score matching within the ESKD cohort, 633 patients with IDD (5.9%) received a kidney transplant compared with 1367 of adults without IDD (12.8%). Adults with IDD were 54% less likely than matched peers without IDD to be evaluated for transplant (odds ratio, 0.46; 95% CI, 0.43-0.50) and 62% less likely to receive a kidney transplant (odds ratio, 0.38; 95% CI, 0.34-0.42). Among matched cohorts of kidney transplant recipients, rates of perioperative complications, readmission, and graft failure were similar for adults with and without IDD.Conclusions and RelevanceUsing the largest cohort of adult kidney transplant recipients with IDD to date, the study team found that rates of evaluation and transplant were lower despite yielding equivalent outcomes. These data support consideration of adults with IDD for kidney transplant and underscore the urgent need for antidiscrimination initiatives to promote the receipt of equitable care for this population.

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“…Preparing the family and team for any medication adjustments needed before and after surgery is important. Using tools to make needed changes simple and trackable for the family can be quite beneficial [ 55 ]. Tools might include a different variation of the daily schedule with specific pictures to assist with tracking water intake.…”

Section: The Adolescent With Special Healthcare Needs and Obesitymentioning

confidence: 99%

Special considerations for the adolescent with obesity: An obesity medicine association (OMA) clinical practice statement (CPS) 2024

Cuda,

O'Hara,

Censani

et al. 2024

Obesity Pillars

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Bariatric Surgery in Children and Adolescents with Cognitive Impairment and/or Developmental Delay: Current Knowledge and Clinical Recommendations

Cited by 11 publications

References 81 publications

Novel subtype of obesity influencing the outcomes of sleeve gastrectomy: Familial aggregation of obesity

Novel subtype of obesity influencing the outcomes of sleeve gastrectomy: Familial aggregation of obesity

Comparing Kidney Transplant Rates and Outcomes Among Adults With and Without Intellectual and Developmental Disabilities

Special considerations for the adolescent with obesity: An obesity medicine association (OMA) clinical practice statement (CPS) 2024

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