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Latest findings from the IFSO Global Registry

Registries offer opportunities to make meaningful comparisons between countries on the demographics, characteristics, operation types and approaches, and trends in metabolic and bariatric surgery (MBS) procedure types, according to the latest paper from the IFSO Global Registry Collaboration. The data presented in the latest paper, represents the key findings of the eighth report of the IFSO Global Registry, which includes data from 24 national and two regional registries, totalling 502,150 procedures.

a) Primary MBS types by country or region (n=449,815)

The authors explained that in 2022, the IFSO Global Registry Committee proposed to the Executive Board of IFSO that future reports include only aggregated data from established national or regional registries using a data dictionary focusing on demographic and descriptive data only. Outcome data was not included as it was inconsistently collected by registries worldwide, making comparisons difficult.


The data revealed that most procedures were primary MBS procedures (n = 449,815 (89.6%)), and with just over 10% revisional procedures (n = 52,335 (10.4%)). The highest rates of revisional MBS were seen in Australia.


b) Revisional MBS types by country or region (n = 52,335). Malaysia (n = 1), Uzbekistan (n = 5), and South Africa (n = 3) cannot be graphically displayed. The United States of America reported an additional 21,057 revisional cases labelled “revision/conversion” that are not able to be displayed graphically. This means the breakdown of procedures displayed in this graph may not be representative

The most commonly performed primary procedure worldwide was sleeve gastrectomy (SG) and the most commonly performed revisional procedure was Roux-en-Y gastric bypass (RYGB). Although the US reported 140,339 primary SG (68.8%), RYGB was the most commonly reported primary MBS in Brazil, Venezuela, Netherlands, Norway, Ontario (Canada), Austria, and Sweden, with one-anastomosis gastric bypass (OAGB) being the most common procedure in Israel and “other” procedures predominating in South Africa (Figures 1a and 1b).


The proportion of people undergoing MBS who also have T2DM ranges from 47.4% for Azerbaijan to 7.7% for France and 11% for the Norwegian and Australian Registries.


In the majority of countries, more women than men have surgery and have surgery as a younger age than their male counterparts, with the exception of China, Kuwait, South Korea, Iran, Italy, and Malaysia. Women are also more likely to have a lower BMI than men. However, men who undergo MBS are more likely to have diabetes.


“These data may suggest that the main driver for men seeking MBS is health concerns rather than weight loss alone,” the authors noted. “These sex-based differences are important considerations when designing patient-focused educational material and guidelines for MBS.”


The lowest median BMI was reported in China (37.5 kg/m2) and South Korea (38.1 kg/m2) on the day of primary MBS. These countries also reported high rates of diabetes in their participants undergoing primary MBS, at 38% and 35%, respectively.


Importantly, the report highlights that mortality following MBS continues to be a rare event in all registries, with rates ranging from 0 to 0.25% in the primary setting and 0–1.42% in the revisional setting, demonstrating the safety of MBS.


The findings were reported in the paper, ‘Metabolic Bariatric Surgery Across the IFSO Chapters: Key Insights on the Baseline Patient Demographics, Procedure Types, and Mortality from the Eighth IFSO Global Registry Report’, published in Obesity Surgery. To access this paper, please click here


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