Impact of Bariatric Surgery Upon the Incidence of Distal Radius Fractures Among Patients With Severe Obesity.

Abstract

Bariatric surgery has been associated with weight loss, amelioration of obesity-related conditions, and improvements in quality of life and longevity. However, there are concerns that bariatric surgery may increase the risks of subsequent fractures through relative malnutrition, metabolic changes, and decreased bone mineral density. The purpose of this study was to determine if a history of bariatric surgery leads to an increased risk of distal radius fractures (DRFs). The PearlDiver Patient Records Database was queried from 2010 to 2023 to identify 4 groups of patients aged >18 years as follows: those who underwent malabsorptive procedures, those who underwent restrictive procedures, those who had obesity eligible for bariatric surgery but did not undergo bariatric surgery, and nonobese controls. Each cohort was matched by age, sex, and nine comorbidities that qualify a patient for bariatric surgery. Multivariable logistic regression controlling for the Elixhauser comorbidity index was performed to compare odds ratios of DRFs. A total of 282,469 patients (87,849 restrictive surgery, 87,849 malabsorptive surgery, 40,804 qualified for bariatric surgery but did not undergo it, and 65,967 nonobese patients) were included in the study. Patients with obesity who qualified for but did not undergo bariatric surgery had higher odds of DRFs at 3 years compared with those who were nonobese. Those who underwent bariatric surgery had lower odds of DRF at 3 years than patients with obesity who qualified for bariatric surgery but did not undergo surgery. Those undergoing malabsorptive surgery did not have a difference in odds of DRFs compared with restrictive surgery. Despite purported metabolic changes associated with bariatric surgery, both malabsorptive and restrictive surgeries decrease a patient's odds of DRFs. Further research is needed to investigate the mechanisms that contribute to these associations. Prognosis II.