title: Trends in utilization of bariatric surgery, 2010-2014: sleeve gastrectomy dominates.
abstract: BACKGROUND
  Bariatric surgery is the most effective treatment for morbid obesity. Furthermore, the proportion of various types of bariatric procedures has significantly changed over the last two decades. Sleeve gastrectomy (SG) has been increasingly chosen as a primary bariatric procedure in recent years.
  
  
  OBJECTIVE
  This study aimed to analyze the changing pattern of bariatric surgery utilization from 2010 to 2014.
  
  
  METHODS
  Using the American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2014.
  
  
  METHODS
  We identified patients aged≥18 years with a body mass index (BMI)≥35 kg/m2undergoing primary bariatric surgery. The trend of surgical procedures was analyzed from 2010 to 2014.
  
  
  RESULTS
  A total of 93,328 patients were included (age of 44.6±11.8 years and BMI of 46.2±7.9 kg/m2). Roux-en-Y gastric bypass (RYGB), adjustable gastric band, and SG comprised 58.4%, 28.8%, and 9.3% of the procedures in 2010 which changed to 37.6%, 3.1%, and 58.2% in 2014, respectively. Baseline BMI of SG patients decreased from 47.5 to 45.6 kg/m2(P< .001). The proportion of diabetic patients undergoing RYGB increased (30.4% to 33.2%, P<.001) but decreased among those having SG (26.6% to 22.8%, P = .001). The proportion of patients with hypertension having RYGB remained unchanged while decreased among SG patients (56.2% to 47.6%, P<.001). Female patients among the SG group increased from 73.2% to 77.7% (P< .001).
  
  
  CONCLUSIONS
  SG has been increasingly performed in the United States superseding adjustable gastric band and RYGB. The trend is in favor of females, lower BMI, and lower ratio of patients with diabetes and hypertension. More data are needed on outcomes of SG to assess its long-term effectiveness and credibility.
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Zhamak
authors.initials: Z
authors.lastname: Khorgami
authors.affiliation: Department of Bariatric and Metabolic Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoar
authors.affiliation: Center for Bariatric Surgery, Department of Surgery, McGill University, Montreal, Canada.
authors.forename: Amin
authors.initials: A
authors.lastname: Andalib
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: aminiaa@ccf.org.
authors.forename: Ali
authors.initials: A
authors.lastname: Aminian
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Brethauer
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Schauer
mesh_terms: D000328:Adult; D017677:Age Distribution; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D005260:Female; D005743:Gastrectomy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011446:Prospective Studies; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology
keywords: Bariatric surgery; Gastric band; Gastric bypass; NSQIP; Obesity; Sleeve gastrectomy; Trend