Predictors for health-related quality of life in patients accepted for bariatric surgery

doi:10.1016/j.soard.2008.11.012

Surgery for Obesity and Related Diseases

Volume 5, Issue 3, May–June 2009, Pages 329-333

https://doi.org/10.1016/j.soard.2008.11.012 Get rights and content

Abstract

Background

The relationship among musculoskeletal pain, depression, and health-related quality of life in patients with severe obesity who are accepted for bariatric surgery should be explored further.

Methods

In this cross-sectional study, we measured the health-related quality of life using the generic questionnaire “Short-Form 36 Health Status Survey.” Multiple regression analysis was used to explore associations between the predictors (musculoskeletal pain and depression) and the physical cumulative summary (PCS) and mental cumulative summary (MCS). Age, gender, body mass index, and the number of co-morbidities were entered as covariates.

Results

The study subjects included 28 women and 23 men, with a mean age of 37.7 years and a mean body mass index of 51.9 kg/m². The PCS and MCS scores were very poor compared with the age- and gender-adjusted population norm (P <.001). The presence of musculoskeletal pain was associated with a score that was 10.97 points lower on the PCS (P <.001) and 7.05 points lower on the MCS (P = .031). The presence of depression was associated with a score that was 20.89 points lower on the MCS (P <.001); no significant association was found between depression and the PCS.

Conclusion

The results of this study have shown that musculoskeletal pain was strongly associated with lower scores on the PCS and MCS, and depression was strongly associated with a lower score on the MCS.

Section snippets

Patients and study design

The first 51 patients with severe obesity who were accepted for biliopancreatic diversion with duodenal switch at Førde Central Hospital were invited to participate in the present study. Our bariatric surgery program was initiated in 2001, and the inclusion criteria were a BMI ≥40.0 kg/m² or ≥35.0–39.9 kg/m² with obesity-related co-morbidities, age 18–60 years, no alcohol or drug problems, no active psychosis, and a failure to lose weight through other methods. All patient data were assessed

Patient characteristics

All patients who were invited agreed to participate in the study. The patients had a high mean BMI and a high prevalence of co-morbidities (Table 1). The patients' PCS and MCS scores were generally very low and were significantly lower than in the norm population (P <.001; Table 2).

Predictors for HRQOL

Having musculoskeletal pain was associated with a score that was 10.97 points lower on the PCS (P <.001; Table 3) and 7.05 points lower on the MCS (P = .031; Table 4). The presence of depression was associated with a

Discussion

The results of this study have shown that musculoskeletal pain is strongly associated with lower scores on the PCS and MCS, and depression is strongly associated with lower score on the MCS. Our secondary analysis also showed that almost all the patients with depression also had musculoskeletal pain, and that these patients had more co-morbidities than the other patients.

Our data support the hypothesis based on the study by Dixon et al. [2] and further suggest that musculoskeletal pain and

Conclusion

Our data have indicated that patients who are accepted for bariatric surgery and experience musculoskeletal pain and/or depression are at particular risk of having lower overall HRQOL. However, more confirmatory research is needed, using a larger sample size and validated instruments for musculoskeletal pain and depression. Future studies evaluating the effect of bariatric surgery on HRQOL should also attempt to identify patients who report no or little improvement in musculoskeletal pain and

Disclosures

The authors claim no commercial associations that might be a conflict of interest in relation to this article.

Acknowledgments

We are grateful for the statistical assistance provided by statistician Tore Wentzel-Larsen, Centre for Clinical Research, Western Norway Regional Health Authority; we also acknowledge the patients who participated in this study.

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: This study was supported by a grant from Sogn and Fjordane College University, Norway.

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Original articlePredictors for health-related quality of life in patients accepted for bariatric surgery

Abstract

Background

Methods

Results

Conclusion

Section snippets

Patients and study design

Patient characteristics

Predictors for HRQOL

Discussion

Conclusion

Disclosures

Acknowledgments

Compr Psychiatry

J Clin Epidemiol

Obesity and health-related quality of life

Obes Rev

Quality of life after lap-band placement: influence of time, weight loss, and comorbidities

Obes Res

Health-related quality of life in patients with class II and class III obesity

Obes Surg

Two measures of health-related quality of life in morbid obesity

Obes Res

Overview of the relationship between pain and obesity: what do we know?Where do we go next?

J Rehabil Res Dev

Depression in association with severe obesity: changes with weight loss

Arch Intern Med

Health-related quality of life in patients seeking gastric bypass surgery vs non-treatment-seeking controls

Obes Surg

Gender, race, and obesity-related quality of life at extreme levels of obesity

Obes Res

Original article
Predictors for health-related quality of life in patients accepted for bariatric surgery