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Study Summary

The SCOTS group have been awarded a grant from the National Institute of Health Research (NIHR) in order to follow patients for 10 years after their surgery to see how well they do. How well they do will include weight loss, surgical complications, diabetes, heart attacks, cancer, anxiety and depression.


SCOTS Approach

SCOTS aims to collect data on every patient in Scotland having weight loss surgery, to monitor their weight, nutrient levels in their blood, whether diabetes gets better or if they develop diabetes in the future, any complications, if quality of life improves and they feel more or less anxious or depressed after the surgery. The study will follow patients for 10 years after their surgery. A vital part of the study is ensuring the patients are fully informed about the study and provide consent to take part.

The study design aims to reduce the burden of data entry on clinical teams except for the collection of a few details at the start (height, weight, age, date and type of surgery). To ensure this happens the aim is to involve the surgeons in the design of the research IT system so that it functions as a clinically useful information system as well as a research tool.

Given the length and complexity of this project, costs are kept low through the use of existing NHS data, providing value for money and ensuring complete follow up. Scotland offers a uniquely suited setting to obtain substantial information via NHS IT systems that would cost millions of pounds if they had to be collected by researchers, to answer many of the questions on effectiveness and safety.


Research Objectives

The SurgiCal Obesity Treatment Study (SCOTS) will establish the clinical outcomes and adverse events of different bariatric surgical procedures, their impact on quality of life and nutritional status, and the effect on co-morbidities in both the short and long term in a cohort of over 2000 patients.


Specific Objectives

To establish in a cohort of obese patients who are undergoing bariatric surgery:

  1. All cause and cause specific mortality over a mean of 10 years since bariatric surgery.

  2. Incidence of cardiovascular disease, cancer and diagnosis of diabetes over a mean of 10 years since bariatric surgery.

  3. Incidence of acute and chronic postoperative complications. Acute complications, defined as up to three months post surgery, will include surgical site infection; chronic complications will include revisional surgery, plastic surgery and chronic pain.

  4. Change in health related quality of life, anxiety and depression over time pre- and post-operatively for a mean of 10 years from date of bariatric surgery.

  5. The micronutrient and weight status pre and post-operatively for a mean of 10 years since bariatric surgery.

  6. The glycaemic control, lipids, blood pressure, medication prescription, and rate of diabetes complications (microalbuminuria and renal disease, retinopathy and foot ulceration) in those that have pre-existing diabetes or develop diabetes during a mean of 10 years follow up since bariatric surgery.