oru.sePublications
Change search
Refine search result
1 - 16 of 16
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Axer, Stephan
    et al.
    Örebro University, School of Medical Sciences.
    Szabo, Eva
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Näslund, Ingmar
    Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Weight loss and alterations in co-morbidities after revisional gastric bypass: A case-matched study from the Scandinavian Obesity Surgery Registry2017In: Surgery for Obesity and Related Diseases, ISSN 1550-7289, E-ISSN 1878-7533, Vol. 13, no 5, p. 796-800Article in journal (Refereed)
    Abstract [en]

    Background: In Sweden, Roux-en-Y gastric bypass is the most common procedure when revising a previous bariatric procedure. This study is an analysis of all revisional gastric bypass operations (rGBP) compared with a matched group of primary gastric bypass (pGBP) operated between 2007 and 2012.

    Objective: The aim was to determine whether improvement of obesity-related co-morbidity and changes in weight after revisional gastric bypass surgery were comparable with those seen after primary surgery.

    Setting: 44 hospitals in Sweden

    Methods: Retrospective data were retrieved from the Scandinavian Obesity Surgery Registry. The study group (rGBP) comprised 1224 patients, and the control group (pGBP) comprised 3612 patients matched for age and gender.

    Results: The indication for revision was weight failure in 512 patients (42%), a late complication of the initial procedure in 330 patients (27%), and a combination of weight failure and complication in 303 patients (25%). A total of 66% of patients in the rGBP group and 67% in the pGBP group completed the 2-year follow-up in the Scandinavian Obesity Surgery Registry.

    The rGBP-group had significantly less excess BMI loss (%EBMIL, 59.4 +/- 147.0 versus 79.5 +/- 24.7, P < .001) and a lower dyslipidemia remission rate (42.9% versus 62.0%, P = .005) at the time of the 2-year follow-up. Remission rates of sleep apnea, hypertension, type 2 diabetes, and depression were similar. The effects on obesity-related co-morbidity were not related to the indication for revisional surgery or the initial bariatric procedure.

    Conclusion: Even if weight results might be inferior compared with primary bypass procedures, the improvement of co-morbidity is similar. (C) 2017 American Society for Metabolic and Bariatric Surgery. All right reserved

  • 2.
    Borg, S.
    et al.
    The Swedish Institute for Health Economics (IHE), Lund, Sweden.
    Näslund, Ingmar
    Surgical department, Örebro University Hospital, Region Örebro län, Örebro, Sweden.
    Persson, U.
    The Swedish Institute for Health Economics (IHE), Lund, Sweden.
    Ödegaard, K.
    The Swedish Institute for Health Economics (IHE), Lund, Sweden.
    Budget impact analysis of surgical treatment for obesity in Sweden2012In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 101, no 3, p. 190-197Article in journal (Refereed)
    Abstract [en]

    Background: The recent substantial increase in the number of obese surgeries performed in Sweden has raised concerns about the budget impact.

    Objective: Our aim in this paper is to present an assessment of the budgetary impact of different policies for surgical intervention for obese and overweight subjects from a healthcare perspective in Sweden.

    Methods: The model simulates the annual expected treatment costs of obesity related diseases and surgery in patients of different sex, age and Body Mass Index (BMI). Costs evaluated are costs of surgery plus the excess treatment costs that an obese patient has over and above the treatment costs of a normal-weight patient. The diagnoses that are included for costs assessment are diabetes and cardiovascular disease since these diagnoses are the principal diagnoses associated with obesity. Four different scenarios over the number of surgical operations performed each year are simulated and compared: (1) no surgical operation, (2) 3 000 surgical operations in persons with BMI > 40, (3) 4 000 (BMI > 40), and (4) 5 000 (expanded to BMI > 38).

    Results: Comparing Scenario 2 with Scenario 1 results in a net budget impact of on average SEK 121 million per annum or SEK 40 000 per patient. This implies that 55 percent of the cost of surgery, set equal to SEK 90 000 for each patient, has been offset by a reduction in the excess treatment costs of obesity related diseases. Expanding annual surgery from 3000 to 4000 the cost-offset increased to 58%. By expanding annual surgery further from 4000 to 5000 and at the same time expanding the indication for surgery from BMI > 40 to BMI > 38, no cost-offset is obtained.

    Conclusion: A cost-minimization strategy for bariatric surgery in Sweden should not expand indication, but rather increase the number of surgeries within the currently accepted indication.

  • 3.
    Carlsson, Lena M. S.
    et al.
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Peltonen, Markku
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
    Ahlin, Sofie
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Anveden, Åsa
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bouchard, Claude
    Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge LA, United States.
    Carlsson, Björn
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Jacobson, Peter
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Lönroth, Hans
    Institute of Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Maglio, Cristina
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Näslund, Ingmar
    Department of Surgery, Örebro University Hospital, Region Örebro län, Örebro, Sweden.
    Pirazzi, Carlo
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Romeo, Stefano
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Sjöholm, Kajsa
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Sjöström, Elisabeth
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Wedel, Hans
    Nordic School of Public Health, Gothenburg, Sweden.
    Svensson, Per-Arne
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Sjöström, Lars
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bariatric Surgery and Prevention of Type 2 Diabetes in Swedish Obese Subjects2012In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 367, no 8, p. 695-704Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Weight loss protects against type 2 diabetes but is hard to maintain with behavioral modification alone. In an analysis of data from a nonrandomized, prospective, controlled study, we examined the effects of bariatric surgery on the prevention of type 2 diabetes.

    METHODS: In this analysis, we included 1658 patients who underwent bariatric surgery and 1771 obese matched controls (with matching performed on a group, rather than individual, level). None of the participants had diabetes at baseline. Patients in the bariatric-surgery cohort underwent banding (19%), vertical banded gastroplasty (69%), or gastric bypass (12%); nonrandomized, matched, prospective controls received usual care. Participants were 37 to 60 years of age, and the body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) was 34 or more in men and 38 or more in women. This analysis focused on the rate of incident type 2 diabetes, which was a prespecified secondary end point in the main study. At the time of this analysis (January 1, 2012), participants had been followed for up to 15 years. Despite matching, some baseline characteristics differed significantly between the groups; the baseline body weight was higher and risk factors were more pronounced in the bariatric-surgery group than in the control group. At 15 years, 36.2% of the original participants had dropped out of the study, and 30.9% had not yet reached the time for their 15-year follow-up examination.

    RESULTS: During the follow-up period, type 2 diabetes developed in 392 participants in the control group and in 110 in the bariatric-surgery group, corresponding to incidence rates of 28.4 cases per 1000 person-years and 6.8 cases per 1000 person-years, respectively (adjusted hazard ratio with bariatric surgery, 0.17; 95% confidence interval, 0.13 to 0.21; P< 0.001). The effect of bariatric surgery was influenced by the presence or absence of impaired fasting glucose (P = 0.002 for the interaction) but not by BMI (P = 0.54). Sensitivity analyses, including end-point imputations, did not change the overall conclusions. The postoperative mortality was 0.2%, and 2.8% of patients who underwent bariatric surgery required reoperation within 90 days owing to complications.

    CONCLUSIONS: Bariatric surgery appears to be markedly more efficient than usual care in the prevention of type 2 diabetes in obese persons. (Funded by the Swedish Research Council and others; ClinicalTrials.gov number, NCT01479452.)

  • 4.
    Edholm, David
    et al.
    Dept Surg Sci, Uppsala Univ, Uppsala, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. School of Health & Medical Science, Univ Örebro, Örebro, Sweden; Dept Surg Sci, Örebro City Council, Örebro, Sweden.
    Karlsson, F. Anders
    Dept Med Sci, Uppsala Univ, Uppsala, Sweden.
    Rask, Eva
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Sundbom, Magnus
    Dept Surg Sci, Uppsala Univ, Uppsala, Sweden.
    Twelve-year results for revisional gastric bypass after failed restrictive surgery in 131 patients2014In: Surgery for Obesity and Related Diseases, ISSN 1550-7289, E-ISSN 1878-7533, Vol. 10, no 1, p. 44-48Article in journal (Refereed)
    Abstract [en]

    Background: Gastric banding (GB) and vertical banded gastroplasty (VBG) may result in unsatisfactory weight loss or intolerable side effects. Such outcomes are potential indications for additional bariatric surgery, and Roux-en-Y gastric bypass is frequently used at such revisions (rRYGB). The present study examined long-term results of rRYGB.

    Methods: In total, 175 patients who had undergone rRYGB between 1993 and 2003 at 2 university hospitals received a questionnaire regarding their current status. The questionnaire was returned by 131 patients (75% follow-up rate, 66 VBG and 65 GB patients). Blood samples were obtained and medical charts studied. The reason for conversion was mainly unsatisfactory weight loss among the VBG patients and intolerable side effects among GB patients.

    Results: The 131 patients (112 women), mean age 41.8 years at rRYGB, were evaluated at mean 11.9 years (range 7-17) after rRYGB. Mean body mass index of those with prior unsatisfactory weight loss was reduced from 40.1 kg/m(2) (range 28.7-52.2) to 32.6 kg/m(2) (range 19.1-50.2) (P < .01). Only 2 patients (2%) underwent additional bariatric surgery after rRYGB. The overall result was satisfactory for 74% of the patients. Only 21% of the patients adhered to the recommendation of lifelong multivitamin supplements while 76% took vitamin B-12. Anemia was present in 18%.

    Conclusions: rRYGB results in sustained weight loss and satisfied patients when VBG or GB have failed. Subsequent bariatric surgery was rare but micronutrient deficiencies were frequent. (C) 2014 American Society for Metabolic and Bariatric Surgery. All rights reserved.

  • 5.
    Eliasson, Bjorn
    et al.
    Dept Mol & Clin Med, Univ Gothenburg, Gothenburg, Sweden; Dept Med, Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Liakopoulos, Vasileios
    Dept Mol & Clin Med, Univ Gothenburg, Gothenburg, Sweden.
    Franzen, Stefan
    Natl Diabetes Register, Registercentrum Västra Götaland, Gothenburg, Sweden.
    Näslund, Ingmar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Dept Surg, Örebro University Hospital, Örebro, Sweden.
    Svensson, Ann-Marie
    Dept Mol & Clin Med, Univ Gothenburg, Gothenburg, Sweden; Natl Diabetes Register, Registercentrum Västra Götaland, Gothenburg, Sweden.
    Ottosson, Johan
    Dept Surg, Örebro University Hospital, Örebro, Sweden.
    Gudbjornsdottir, Soffia
    Dept Mol & Clin Med, Univ Gothenburg, Gothenburg, Sweden; Natl Diabetes Register, Registercentrum Västra Götaland, Gothenburg, Sweden.
    Cardiovascular disease and mortality in patients with type 2 diabetes after bariatric surgery in Sweden: a nationwide, matched, observational cohort study2015In: The Lancet Diabetes and Endocrinology, ISSN 2213-8587, E-ISSN 2213-8595, Vol. 3, no 11, p. 847-854Article in journal (Refereed)
    Abstract [en]

    Background In patients with diabetes and obesity specifically, no studies have examined mortality after bariatric surgery. We did a nationwide study in Sweden to examine risks of cardiovascular disease and mortality in patients with obesity and diabetes who had undergone bariatric surgery (Roux-en-Y gastric bypass [RYGB]). Methods In this nationwide, matched, observational cohort study, we merged data for patients who had undergone RYGB registered in the Scandinavian Obesity Surgery Registry with other national databases, and identified matched controls (on the basis of sex, age, BMI, and calendar time [year]) who had not undergone bariatric surgery from the National Diabetes Registry. We assessed risks of cardiovascular disease and death using a Cox proportional-hazards regression model and other methods to examine the treatment effect while accounting for residual confounding. Primary outcomes were total mortality, cardiovascular death, and fatal or non-fatal myocardial infarction. Findings Between Jan 1, 2007, and Dec 31, 2014, we obtained data for 6132 patients who had undergone RYGB and 6132 control patients who had not. Median follow-up was 3.5 years (IQR 2.1-4.7). We noted a 58% relative risk reduction (hazard ratio [HR] 0.42, 95% CI 0.30-0.57; p< 0.0001) in overall mortality in the RYGB group compared with the controls. The risk of fatal or non-fatal myocardial infarction was 49% lower (HR 0.51, 0.29-0.91; p= 0.021) and that of cardiovascular death was 59% lower (0.41, 0.19-0.90; p= 0.026) in the RYGB group than in the control group. 5 year absolute risks of death were 1.8% (95% CI 1.5-2.2) in the RYGB group and 5.8% (5.0-6.8) in the control group. Interpretation Our findings provide support for the benefits of RYGB surgery for patients with obesity and type 2 diabetes. The causes of these beneficial effects may be the weight reduction per se, changes in physiology and metabolism, improved care and treatment, improvements in lifestyle and risk factors, or combinations of these factors.

  • 6.
    Karefylakis, Christos
    et al.
    Dept Endocrinol, Div Internal Med, Örebro Univ Hosp, Örebro, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. Div Surg, Örebro University Hospital, Örebro, Sweden.
    Edholm, David
    Dept Surg Sci, Uppsala Univ, Uppsala, Sweden.
    Sundbom, Magnus
    Dept Surg Sci, Uppsala Univ, Uppsala, Sweden.
    Karlsson, F. Anders
    Inst Med Sci, Uppsala Univ, Uppsala, Sweden.
    Rask, Eva
    Ctr Hlth Care Sci, Örebro University Hospital, Örebro, Sweden.
    Vitamin D Status 10 Years After Primary Gastric Bypass: Gravely High Prevalence of Hypovitaminosis D and Raised PTH Levels2014In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 24, no 3, p. 343-348Article in journal (Refereed)
    Abstract [en]

    The primary aim of this study was to evaluate the prevalence of vitamin D deficiency and secondary hyperparathyroidism after Roux-en-Y gastric bypass. Secondly, we have tried to assess predictors for vitamin D deficiency. Five hundred thirty-seven patients who underwent primary Roux-en-Y gastric bypass surgery between 1993 and 2003 at the A-rebro University Hospital and Uppsala University Hospital were eligible for the study. Patients were asked to provide a blood sample between November 2009 and June 2010 and to complete a questionnaire about their postoperative health status. Serum values of 25-OH vitamin D, parathyroid hormone (PTH), alkaline phosphatase (ALP) and calcium were determined. Follow-up was completed in 293 patients, of which 83 % were female, with an age of 49 +/- 9.9 years after a median time of 11 +/- 2.8 years. Vitamin D, PTH and albumin-corrected calcium values were 42 +/- 20.4 nmol/L, 89.1 +/- 52.7 ng/L and 2.3 +/- 0.1 mmol/L, respectively. Of all patients, 65 % were vitamin D deficient, i.e. 25-OH vitamin D < 50 nmol/L, and 69 % had PTH above the upper normal reference range, i.e. > 73 ng/L. Vitamin D was inversely correlated with PTH levels (p < 0.001) and positively correlated with calcium (p = 0.016). Vitamin D did not correlate with ALP. The only factor found to predict vitamin D deficiency was high preoperative body mass index (BMI) (p = 0.008), whereas gender, age, time after surgery and BMI at follow-up did not. Vitamin D deficiency and secondary hyperparathyroidism after Roux-en-Y gastric bypass (RYGB) were confirmed in our study because 65 % of patients had vitamin D deficiency, and 69 % had increased PTH levels more than 10 years after surgery. These data are alarming and highlight the need for improved long-term follow-up. Vitamin D deficiency does not seem to progress with time after surgery, possibly due to weight loss. Only preoperative BMI, cutoff point 43 kg/m(2), was a predictor of vitamin D deficiency at follow-up. Improved long-term follow-up of patients that undergo RYGB is needed.

  • 7.
    Larsson, I.
    et al.
    Dept Endocrinol Diabetol & Metab Internal Med, Sahlgrenska Univ Hosp, Univ Gothenburg, Gothenburg, Sweden.
    Lissner, L.
    Publ Hlth Epidemiol Unit, Dept Publ Hlth & Community Med, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Samuelson, G.
    Dept Nursing Hlth & Culture, Univ West, Trollhättan, Sweden.
    Fors, H.
    Dept Paediat, Northern Älvsborg Hosp, Trollhättan, Sweden.
    Lantz, H.
    Sahlgrenska Univ Hosp, Dept Endocrinol Diabetol & Metab Internal Med, Univ Gothenburg, Gothenburg, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Carlsson, L. M. S.
    Dept Mol & Clin Med, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Sjoström, L.
    Dept Mol & Clin Med, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden..
    Bosaeus, I.
    Dept Endocrinol Diabetol & Metab Internal Med, Sahlgrenska Univ Hosp, Univ Gothenburg, Gothenburg, Sweden.
    Body composition through adult life: Swedish reference data on body composition2015In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 69, no 7, p. 837-842Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: The prevalence of obesity, defined as body mass index (BMI) >= 30 kg/m(2), differs between populations; however, there is a need for data on description on body composition in reference populations of different ages and from different countries. The objective of this study was to pool dual-energy X-ray absorptiometry (DXA) body composition reference data from population-based Swedish cohorts.

    SUBJECTS/METHODS: Four population-based cross-sectional cohort studies including 1424 adult Swedes were divided into five age groups (20-29, 30-39, 40-49, 50-61 and 75 years of age); BMI 24.6 +/- 3.9 kg/m(2) were pooled. Body composition was measured with DXA.

    RESULTS: The difference in BMI from the youngest to the oldest age group was 3.2 and 4.3 kg/m(2) in men and women, respectively (P<0.001, both sexes), and fat mass (FM) was 9.9 and 9.1% higher in the oldest compared with the youngest men and women (P<0.001, both sexes). Fat-free mass (FFM) remained stable up to 60 years of age in men (P = 0.83) and was lower at 75 years of age compared with the younger ages. In women, FFM was lower from age 60. From youngest to oldest age groups, height-adjusted FM differed from 4.6 to 7.8 kg/m(2) in men and from 6.8 to 10.8 kg/m(2) in women (P<0.001, both sexes).

    CONCLUSIONS: Our results provide reference data on body composition in Swedish populations. BMI and FM were higher among older age groups compared with the younger ones. FFM remained stable up to 60 years of age and was lower first among the 75 years of age.

  • 8.
    Laurenius, Anna
    et al.
    Dept Gastrosurg Res & Educ, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Olbers, Torsten
    Dept Gastrosurg Res & Educ, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. Dept Upper Gastrosurg Res.
    Karlsson, Jan
    Örebro University Hospital. Inst Hlth & Care Sci, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Ctr Hlth Care Sci, Örebro University Hospital, Örebro, Sweden.
    Dumping Syndrome Following Gastric Bypass: Validation of the Dumping Symptom Rating Scale2013In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 23, no 6, p. 740-755Article in journal (Refereed)
    Abstract [en]

    There is a lack of prevalent data for dumping syndrome (DS) and methods discriminating between different symptoms of the DS. A self-assessment questionnaire, the Dumping Symptom Rating Scale (DSRS), was developed. The aim was to measure the severity and frequency of nine dumping symptoms and to evaluate the construct validity of the DSRS. Pre- and 1 and 2 years after Roux-en-Y gastric bypass surgery, 47 adults and 82 adolescents completed the DSRS. Cognitive interview was performed. Reliability and construct validity were tested. Effect sizes (ES) of changes were calculated. Patients found the questionnaire relevant. A high proportion of the respondents reported no symptoms affecting them negatively at all (floor effects). However, 12 % stated, quite severe, severe, or very severe problems regarding fatigue after meal and half of them were so tired that they needed to lie down. Nearly 7 % reported quite severe, severe, or very severe problems dominated by nausea and 6 % dominated by fainting esteem. The internal consistency reliability was adequate for both severity (0.81-0.86) and frequency (0.76-0.84) scales. ES were small, since some subjects experienced symptoms already preoperatively. Although most patients reported no or mild dumping symptoms 1 and 2 years after gastric bypass surgery, around 12 % had persistent symptoms, in particular, postprandial fatigue, and needed to lie down. Another 7 % had problems with nausea and 6 % had problems with fainting esteem. The DSRS is a reliable screening tool to identify these patients.

  • 9.
    Raoof, Mustafa
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Näslund, Ingmar
    Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Rask, Eva
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Karlsson, Jan
    Örebro University Hospital. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden; Department of Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden .
    Sundbom, Magnus
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Edholm, David
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Karlsson, F. Anders
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Svensson, Felicity
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Szabo, Eva
    Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden .
    Health-Related Quality-of-Life (HRQoL) on an Average of 12 Years After Gastric Bypass Surgery2015In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 25, no 7, p. 1119-1127Article in journal (Refereed)
    Abstract [en]

    It is evident that morbidly obese patients have a low health-related quality-of-life (HRQoL), and this low HRQoL has become a common reason for them to seek bariatric surgery. Several HRQoL studies demonstrate a dramatic postoperative improvement, but most of these have had a short follow-up period.

    An observational, cross-sectional study for HRQoL was conducted to study 486 patients (average age of 50.7 +/- 10.0 years, with 84 % of them being female) operated with gastric bypass (GBP) in the period 1993 to 2003 at the University Hospitals of A-rebro and Uppsala. Mean follow-up after gastric bypass was 11.5 +/- 2.7 years (range 7-17). Two HRQoL instruments were used, SF-36 and the Obesity-related Problems scale (OP). The study group was compared with two control groups, both matched for age and gender, one from the general population and one containing morbidly obese patients evaluated and awaiting bariatric surgery.

    The study group scored better in the SF-36 domains (all four physical domains and the vitality subscore) and OP scale compared to obese controls, but their HRQoL scores were lower than those of the general population. HRQoL was better among younger patients and in the following subgroups: men, patients with satisfactory weight loss, satisfied with the procedure, free from co-morbidities and gastrointestinal symptoms, employment, good oral status and those not hospitalised or regularly followed up for non-bariatric reasons.

    Long-term follow-up after GBP for morbid obesity showed better scores in most aspects of HRQoL compared to obese controls but did not achieve the levels of the general population. Patients with better medical outcome after gastric bypass operation had better HRQoL.

  • 10.
    Sjöström, Lars
    et al.
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Peltonen, Markku
    Natl Inst Hlth & Welf, Dept Chron Dis Prevent, Helsinki, Finland..
    Jacobson, Peter
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Ahlin, Sofie
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Andersson-Assarsson, Johanna
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Anveden, Asa
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Bouchard, Claude
    Pennington Biomed Res Ctr, Louisiana State Univ Syst, Baton Rouge LA, USA..
    Carlsson, Bjorn
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Karason, Kristjan
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Lönroth, Hans
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Sjöström, Elisabeth
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Taube, Magdalena
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Wedel, Hans
    Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden; Nord Sch Publ Hlth, Gothenburg, Sweden.
    Svensson, Per-Arne
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Sjöholm, Kajsa
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Carlsson, Lena M. S.
    Inst Med, Univ Gothenburg, Gothenburg, Sweden.
    Association of Bariatric Surgery With Long-term Remission of Type 2 Diabetes and With Microvascular and Macrovascular Complications2014In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 311, no 22, p. 2297-2304Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE Short-term studies show that bariatric surgery causes remission of diabetes. The long-term outcomes for remission and diabetes-related complications are not known.

    OBJECTIVES: To determine the long-term diabetes remission rates and the cumulative incidence of microvascular and macrovascular diabetes complications after bariatric surgery.

    DESIGN, SETTING, AND PARTICIPANTS: The Swedish Obese Subjects (SOS) is a prospective matched cohort study conducted at 25 surgical departments and 480 primary health care centers in Sweden. Of patients recruited between September 1,1987, and January 31, 2001, 260 of 2037 control patients and 343 of 2010 surgery patients had type 2 diabetes at baseline. For the current analysis, diabetes status was determined at SOS health examinations until May 22, 2013. Information on diabetes complications was obtained from national health registers until December 31, 2012. Participation rates at the 2-, 10-, and 15-year examinations were 81%, 58%, and 41% in the control group and 90%, 76%, and 47% in the surgery group. For diabetes assessment, the median follow-up time was 10 years (interquartile range [IQR], 2-15) and 10 years (IQR, 10-15) in the control and surgery groups, respectively. For diabetes complications, the median follow-up time was 17.6 years (IQR, 14.2-19.8) and 18.1 years (IQR, 15.2-21.1) in the control and surgery groups, respectively.

    INTERVENTIONS: Adjustable or nonadjustable banding (n = 61), vertical banded gastroplasty (n = 227), or gastric bypass (n = 55) procedures were performed in the surgery group, and usual obesity and diabetes care was provided to the control group.

    MAIN OUTCOMES AND MEASURES: Diabetes remission, relapse, and diabetes complications. Remission was defined as blood glucose <110 mg/dL and no diabetes medication.

    RESULTS: The diabetes remission rate 2 years after surgery was 16.4% (95% CL, 11.7%-22.2%; 34/207) for control patients and 72.3% (95% Cl, 66.9%-77.2%; 219/303) for bariatric surgery patients (odds ratio [OR], 13.3; 95% Cl, 8.5-20.7; P < .001). At 15 years, the diabetes remission rates decreased to 6.5% (4/62) for control patients and to 30.4% (35/115) for bariatric surgery patients (OR, 6.3; 95% Cl, 2.1-18.9; P < .001). With long-term follow-up, the cumulative incidence of microvascular complications was 41.8 per 1000 person-years (95% Cl, 35.3-49.5) for control patients and 20.6 per 1000 person-years (95% Cl, 17.0-24.9) in the surgery group (hazard ratio [HR], 0.44; 95% Cl, 0.34-0.56; P < .001). Macrovascular complications were observed in 44.2 per 1000 person-years (95% Cl, 37.5-52.1) in control patients and 31.7 per 1000 person-years (95% Cl, 27.0-37.2) for the surgical group (HR, 0.68; 95% Cl, 0.54-0.85; P = .001).

    CONCLUSIONS AND RELEVANCE: In this very long-term follow-up observational study of obese patients with type 2 diabetes, bariatric surgery was associated with more frequent diabetes remission and fewer complications than usual care. These findings require confirmation in randomized trials.

  • 11.
    Stenberg, Erik
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Szabo, Eva
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Ottosson, Johan
    Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Outcomes of laparoscopic gastric bypass in a randomized clinical trial compared with a concurrent national database2017In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 104, no 5, p. 562-569Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: RCTs are the standard for assessing medical interventions, but they may not be feasible and their external validity is sometimes questioned. This study aimed to compare results from an RCT on mesenteric defect closure during laparoscopic gastric bypass with those from a national database containing data on the same procedure, to shed light on the external validity of the RCT.

    METHODS: Patients undergoing laparoscopic gastric bypass surgery within an RCT conducted between 1 May 2010 and 14 November 2011 were compared with those who underwent the same procedure in Sweden outside the RCT over the same time interval. Primary endpoints were severe complications within 30 days and surgery for small bowel obstruction within 4 years.

    RESULTS: Some 2507 patients in the RCT were compared with 8485 patients in the non-RCT group. There were no differences in severe complications within 30 days in the group without closure of the mesenteric defect (odds ratio (OR) for RCT versus non-RCT 0·94, 95 per cent c.i. 0·64 to 1·36; P = 0·728) or in the group with closure of the defect (OR 1·34, 0·96 to 1·86; P = 0·087). There were no differences between the RCT and non-RCT cohorts in reoperation rates for small bowel obstruction in the mesenteric defect non-closure (cumulative incidence 10·9 versus 9·4 per cent respectively; hazard ratio (HR) 1·20, 95 per cent c.i. 0·99 to 1·46; P = 0·065) and closure (cumulative incidence 5·7 versus 7·0 per cent; HR 0·82, 0·62 to 1·07; P = 0·137) groups. The relative risk for small bowel obstruction without mesenteric defect closure compared with closure was 1·91 in the RCT group and 1·39 in the non-RCT group.

    CONCLUSION: The efficacy of mesenteric defect closure was similar in the RCT and national registry, providing evidence for the external validity of the RCT.

  • 12.
    Stenberg, Erik
    et al.
    Örebro University Hospital. Department of Surgery, Lindesberg Hospital, Lindesberg, Sweden; Department of Surgery, Örebro University Hospital, Örebro, Sweden .
    Szabo, Eva
    Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Ågren, Göran
    Department of Surgery, Örebro University Hospital, Örebro, Sweden .
    Näslund, Erik
    Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden .
    Boman, Lars
    Department of Surgery, Lycksele Hospital, Lycksele, Sweden .
    Bylund, Ami
    Department of Surgery, Ersta Hospital, Stockholm, Sweden .
    Hedenbro, Jan
    Skåne University Hospital, Lund University, Lund, Sweden; Department of Surgery, Aleris Obesity Skåne, Lund, Sweden .
    Laurenius, Anna
    Department of Surgery, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden .
    Lundegårdh, Göran
    Österlenskirurgin, Simrishamn Hospital, Simrishamn, Sweden .
    Lönroth, Hans
    Österlenskirurgin, Simrishamn Hospital, Simrishamn, Sweden .
    Möller, Peter
    Department of Surgery, Kalmar County Hospital, Kalmar, Sweden .
    Sundbom, Magnus
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden .
    Ottosson, Johan
    Örebro University Hospital. Department of Surgery, Lindesberg Hospital, Lindesberg, Sweden; Department of Surgery, Örebro University Hospital, Örebro, Sweden .
    Näslund, Ingmar
    Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Early complications after laparoscopic gastric bypass surgery: results from the Scandinavian Obesity Surgery Registry2014In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 260, no 6, p. 1040-1047Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To identify risk factors for serious and specific early complications of laparoscopic gastric bypass surgery using a large national cohort of patients.

    BACKGROUND: Bariatric procedures are among the most common surgical procedures today. There is, however, still a need to identify preoperative and intraoperative risk factors for serious complications.

    METHODS: From the Scandinavian Obesity Surgery Registry database, we identified 26,173 patients undergoing primary laparoscopic gastric bypass operation for morbid obesity between May 1, 2007, and September 30, 2012. Follow-up on day 30 was 95.7%. Preoperative data and data from the operation were analyzed against serious postoperative complications and specific complications.

    RESULTS: The overall risk of serious postoperative complications was 3.4%. Age (adjusted P = 0.028), other additional operation [odds ratio (OR) = 1.50; confidence interval (CI): 1.04-2.18], intraoperative adverse event (OR = 2.63; 1.89-3.66), and conversion to open surgery (OR = 4.12; CI: 2.47-6.89) were all risk factors for serious postoperative complications. Annual hospital volume affected the rate of serious postoperative complications. If the hospital was in a learning curve at the time of the operation, the risk for serious postoperative complications was higher (OR = 1.45; CI: 1.22-1.71). The 90-day mortality rate was 0.04%.

    CONCLUSIONS: Intraoperative adverse events and conversion to open surgery are the strongest risk factors for serious complications after laparoscopic gastric bypass surgery. Annual operative volume and total institutional experience are important for the outcome. Patient related factors, in particular age, also increased the risk but to a lesser extent.

  • 13.
    Sundbom, Magnus
    et al.
    Department of Surgical Sciences, Upper Gastrointestinal Surgery, Uppsala University Hospital, Uppsala, Sweden.
    Hedberg, Jakob
    Department of Surgical Sciences, Upper Gastrointestinal Surgery, Uppsala University Hospital, Uppsala, Sweden.
    Marsk, Richard
    Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Boman, Lars
    Department of Surgery, Lycksele Hospital, Lycksele, Sweden.
    Bylund, Ami
    Department of Surgery, Ersta Hospital, Stockholm, Sweden.
    Hedenbro, Jan
    Aleris Obesity and Clinical Sciences, Lund University, Lund, Sweden.
    Laurenius, Anna
    Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Lundegårdh, Göran
    Österlenskirurgin, Simrishamn Hospital, Simrishamn, Sweden.
    Möller, Peter
    Department of Surgery, Kalmar County Hospital, Kalmar, Sweden.
    Olbers, Torsten
    Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Ottosson, Johan
    Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Näslund, Erik
    Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Substantial Decrease in Comorbidity 5 Years After Gastric Bypass: A Population-based Study From the Scandinavian Obesity Surgery Registry2017In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 265, no 6, p. 1166-1171Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate effect on comorbid disease and weight loss 5 years after Roux-en-Y gastric bypass (RYGB) surgery for morbid obesity in a large nationwide cohort.

    BACKGROUND: The number patients having surgical procedures to treat obesity and obesity-related disease are increasing. Yet, population-based, long-term outcome studies are few.

    METHODS: Data on 26,119 individuals [75.8% women, 41.0 years, and body mass index (BMI) 42.8 kg/m] undergoing primary RYGB between May 1, 2007 and June 30, 2012, were collected from 2 Swedish quality registries: Scandinavian Obesity Surgery Registry and the Prescribed Drug Registry. Weight, remission of type 2 diabetes mellitus, hypertension, dyslipidemia, depression, and sleep apnea, and changes in corresponding laboratory data were studied. Five-year follow-up was 100% (9774 eligible individuals) for comorbid diseases.

    RESULTS: BMI decreased from 42.8 ± 5.5 to 31.2 ± 5.5 kg/m at 5 years, corresponding to 27.7% reduction in total body weight. Prevalence of type 2 diabetes mellitus (15.5%-5.9%), hypertension (29.7%-19.5%), dyslipidemia (14.0%-6.8%), and sleep apnea (9.6%-2.6%) was reduced. Greater weight loss was a positive prognostic factor, whereas increasing age or BMI at baseline was a negative prognostic factor for remission. The use of antidepressants increased (24.1%-27.5%). Laboratory status was improved, for example, fasting glucose and glycated hemoglobin decreased from 6.1 to 5.4 mmol/mol and 41.8% to 37.7%, respectively.

    CONCLUSIONS: In this nationwide study, gastric bypass resulted in large improvements in obesity-related comorbid disease and sustained weight loss over a 5-year period. The increased use of antidepressants warrants further investigation.

  • 14.
    Sundström, Johan
    et al.
    Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
    Bruze, Gustaf
    Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
    Ottosson, Johan
    Örebro University Hospital. Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden.
    Marcus, Claude
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden.
    Neovius, Martin
    Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
    Weight Loss and Heart Failure: A Nationwide Study of Gastric Bypass Surgery Versus Intensive Lifestyle Treatment2017In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 135, no 17, p. 1577-1585Article in journal (Refereed)
    Abstract [en]

    Background: Associations of obesity with incidence of heart failure have been observed, but the causality is uncertain. We hypothesized that gastric bypass surgery leads to lower incidence of heart failure compared to intensive lifestyle modification in obese people.

    Methods: We included obese people without previous heart failure from a Swedish nationwide registry of people treated with a structured intensive lifestyle program, and the Scandinavian Obesity Surgery Registry. All analyses used inverse probability weights, based on baseline body-mass index and a propensity score estimated using baseline variables. Treatment groups were well balanced regarding weight, body mass index and most potential confounders. Associations of treatment with heart failure incidence, as defined in the National Patient Register, were analyzed using Cox regression.

    Results: The 25,804 gastric bypass surgery patients had on average lost 18.8 kg more weight after 1 year, and 22.6 kg more after 2 years, than the 13,701 lifestyle modification patients. During a median of 4.1 years, surgery patients had lower heart failure incidence than lifestyle modification patients (hazard ratio 0.54, 95% CI 0.36-0.82). A 10 kg achieved weight loss after 1 year was related to a hazard ratio for heart failure of 0.77, 95% confidence interval 0.60 to 0.97, in both treatment groups combined. Results were robust in sensitivity analyses.

    Conclusions: Gastric bypass surgery was associated with approximately one half the incidence of heart failure compared with intensive lifestyle modification in this study of two large nationwide registries. We also observed a graded association between increasing weight loss and decreasing risk of heart failure.

  • 15.
    Svensson, Per-Arne
    et al.
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Anveden, Asa
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Romeo, Stefano
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Peltonen, Markku
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Ahlin, Sofie
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Burza, Maria Antonella
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Carlsson, Bjorn
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Jacobson, Peter
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Lindroos, Anna-Karin
    Food Data Div, Natl Food Agcy, Uppsala, Sweden.
    Lonroth, Hans
    Inst Clin Sci, Dept Surg, Sahlgrenska Acad, Gothenburg Univ, Gothenburg, Sweden.
    Maglio, Cristina
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Näslund, Ingmar
    Örebro University Hospital. Dept Surg.
    Sjoholm, Kajsa
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Wedel, Hans
    Nordic School of Public Health, Gothenburg, Sweden.
    Soderpalm, Bo
    Inst Neurosci & Physiol, Sahlgrenska Acad, Gothenburg Univ, Gothenburg, Sweden.
    Sjostrom, Lars
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Carlsson, Lena M. S.
    Inst Med, Dept Mol & Clin Med, Sahlgrenska Academy, Gothenburg Univ, Gothenburg, Sweden.
    Alcohol consumption and alcohol problems after bariatric surgery in the swedish obese subjects study2013In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 21, no 12, p. 2444-2451Article in journal (Refereed)
    Abstract [en]

    Objective Increased sensitivity to alcohol after gastric bypass has been described. The aim of this study was to investigate whether bariatric surgery is associated with alcohol problems. Design and Methods The prospective, controlled Swedish Obese Subjects (SOS) study enrolled 2,010 obese patients who underwent bariatric surgery (68% vertical banded gastroplasty (VBG), 19% banding, and 13% gastric bypass) and 2,037 matched controls. Patients were recruited between 1987 and 2001. Data on alcohol abuse diagnoses, self-reported alcohol consumption, and alcohol problems were obtained from the National Patient Register and questionnaires. Follow-up time was 8-22 years. Results During follow-up, 93.1% of the surgery patients and 96.0% of the controls reported alcohol consumption classified as low risk by the World Health Organization (WHO). However, compared to controls, the gastric bypass group had increased risk of alcohol abuse diagnoses (adjusted hazard ratio [adjHR] = 4.97), alcohol consumption at least at the WHO medium risk level (adjHR = 2.69), and alcohol problems (adjHR = 5.91). VBG increased the risk of these conditions with adjHRs of 2.23, 1.52, and 2.30, respectively, while banding was not different from controls. Conclusions Alcohol consumption, alcohol problems, and alcohol abuse are increased after gastric bypass and VBG.

  • 16.
    Wengström, Yvonne
    et al.
    Department of Nursing Research, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology, Radiumhemmet, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Forsberg, Christina
    Department of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; The Swedish Red Cross University College of Nursing, Stockholm, Sweden.
    Näslund, Ingmar
    Department of Oncology, Radiumhemmet, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Bergh, Jonas
    Department of Oncology, Radiumhemmet, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Quantitative assessment of skin erythema due to radiotherapy: evaluation of different measurements2004In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 72, no 2, p. 191-197Article in journal (Refereed)
    Abstract [en]

    Background and purpose: Visual assessment is the most common clinical investigation of skin reactions in radiotherapy. Due to the unquantitative and subjective nature of this method additional non-invasive methods are needed for more accurate evaluation of the visible acute adverse skin reactions due to radiotherapy. The purpose of this study was to evaluate a new objective measure with regard to reliability and validity and compare it with an established objective measure and a visual assessment. Patients and methods: A sample of 53 consecutive patients commencing curative tangential radiation therapy to the breast parenchyma were included in the study. The skin area of the treated breast was divided into five sections and assessed individually at 0, 24 and 50 Gy. The RTOG scoring system was used for the visual assessment of the skin reactions. The first objective measure included reflectance spectrometry (DermaSpectrometer) measures at fixed points within the treatment area. For the second objective measure digital images (Camera) were taken with a system using a digital camera and software. The images were analyzed using the Adobe Photoshop 5.0 software program. Results: The results provided significant evidence of the test-retest reliability of the camera. The correlation between the objective measures proved to be significant as the treatment progressed. Conclusions: The results suggest that the camera may be used in a reliable and valid way to measure skin erythema due to radiotherapy. (C) 2004 Published by Elsevier Ireland Ltd.

1 - 16 of 16
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf