Roux-en-Y gastric bypass tied to risk for alcohol use disorder hospitalization

Roux-en-Y gastric bypass (RYGB) is associated with an increased risk for alcohol use disorder (AUD)-related hospitalizations versus both sleeve gastrectomy and weight management programs, according to a study published online Dec. 14 in JAMA Surgery.

Nadim Mahmud, M.D., from the University of Pennsylvania in Philadelphia, and colleagues evaluated the effect of RYGB, sleeve gastrectomy, or gastric banding on subsequent AUD-related hospitalization and all-cause mortality versus referral to the MOVE! weight management program alone. The analysis included 1,854 patients (body mass index ≥30 kg/m²) treated at 127 Veterans Health Administration health centers.

The researchers found that accounting for time-updating alcohol use and body mass index, RYGB was associated with an increased risk for AUD-related hospitalization versus MOVE! (hazard ratio [HR], 1.70; 95 percent confidence interval [CI], 1.20 to 2.41; P = 0.003) and versus sleeve gastrectomy (HR, 1.98; 95 percent CI, 1.55 to 2.53; P < 0.001). There was no significant difference observed in AUD-related hospitalization between sleeve gastrectomy and MOVE! (HR, 0.76; 95 percent CI, 0.56 to 1.03; P = 0.08). While RYGB was associated with a lower mortality risk compared with MOVE! (HR, 0.63; 95 percent CI, 0.49 to 0.81; P < 0.001), this association was diminished by increasing alcohol use over time.

"The mortality benefit associated with RYGB was diminished by increased alcohol use, highlighting the importance of careful patient selection and alcohol-related counseling for patients undergoing this procedure," the authors write.

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