TY - JOUR
T1 - Discordance in prediction for prognosis of type 2 diabetes after metabolic surgery
T2 - Comparison of the ABCD, DiaRem, and individualized metabolic surgery models
AU - Ha, Jane
AU - Kwon, Yeongkeun
AU - Kim, Nam Hoon
AU - Park, Sungsoo
AU - Menzo, Emanuele Lo
AU - Rosenthal, Raul J.
N1 - Publisher Copyright:
Copyright © 2019, the Korean Surgical Society
PY - 2019
Y1 - 2019
N2 - Purpose: Metabolic surgery has been performed as a treatment option for uncontrolled type 2 diabetes (T2D), and several scoring systems for predicting postoperative T2D remission have been proposed. This study was designed to assess consistency of 3 existing scoring systems in patients with T2D duration <1 year. Methods: This study included 186 patients with T2D enrolled in a university hospital prospective database between 2011 and 2013. Externally validated scoring systems for predicting T2D prognosis after metabolic surgery were identified and selected through systematic literature search. We assessed concordance between ABCD, DiaRem, and individualized metabolic surgery (IMS) scores in participants using kappa statistical analysis and 1-way analysis of variance. Results: Of the participants, 52 and 82 patients were expected to have favorable T2D remission after metabolic surgery with ABCD score of 10-5 and DiaRem score of 0-7, respectively, and a slight-to-fair concordance was shown between the 2 scoring systems (kappa measure, 0.07; standard error [SE], 0.05 and kappa measure, 0.25; SE, 0.19, respectively). The DiaRem score increased with T2D severity determined by IMS score (P < 0.001), while the ABCD score showed no significant association with IMS score. Conclusion: ABCD and DiaRem scores showed significant discordance when applied to potential metabolic surgery candidates in whom postoperative T2D remission rate was highly expected. The IMS score showed a dose-response association with DiaRem score but had no significant association with the ABCD score.
AB - Purpose: Metabolic surgery has been performed as a treatment option for uncontrolled type 2 diabetes (T2D), and several scoring systems for predicting postoperative T2D remission have been proposed. This study was designed to assess consistency of 3 existing scoring systems in patients with T2D duration <1 year. Methods: This study included 186 patients with T2D enrolled in a university hospital prospective database between 2011 and 2013. Externally validated scoring systems for predicting T2D prognosis after metabolic surgery were identified and selected through systematic literature search. We assessed concordance between ABCD, DiaRem, and individualized metabolic surgery (IMS) scores in participants using kappa statistical analysis and 1-way analysis of variance. Results: Of the participants, 52 and 82 patients were expected to have favorable T2D remission after metabolic surgery with ABCD score of 10-5 and DiaRem score of 0-7, respectively, and a slight-to-fair concordance was shown between the 2 scoring systems (kappa measure, 0.07; standard error [SE], 0.05 and kappa measure, 0.25; SE, 0.19, respectively). The DiaRem score increased with T2D severity determined by IMS score (P < 0.001), while the ABCD score showed no significant association with IMS score. Conclusion: ABCD and DiaRem scores showed significant discordance when applied to potential metabolic surgery candidates in whom postoperative T2D remission rate was highly expected. The IMS score showed a dose-response association with DiaRem score but had no significant association with the ABCD score.
KW - Bariatric surgery
KW - Prognosis
KW - Scores
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=85077197020&partnerID=8YFLogxK
U2 - 10.4174/astr.2019.97.6.309
DO - 10.4174/astr.2019.97.6.309
M3 - Article
AN - SCOPUS:85077197020
SN - 2288-6575
VL - 97
SP - 309
EP - 318
JO - Annals of Surgical Treatment and Research
JF - Annals of Surgical Treatment and Research
IS - 6
ER -
