Materials and methods
Patients
Quality of life (QoL)
RAND-36
Analysing the questionnaire
Comparing to the Dutch reference population
Postoperative influences on the QoL outcomes
Comparison between SG and RYGB
Sleeve gastrectomy | Roux-en-Y gastric bypass | p-value | |||
---|---|---|---|---|---|
N | % | N | % | ||
Number of patients | 965 | 19.8% | 3899 | 80.2% | |
Gender (female) | 745 | 77.2% | 3152 | 80.8% | 0.013* |
Weight (median, kg, IQR) | 133.9 | (119.4–155.0) | 123.9 | (113.0–136.4) | < 0.001* |
BMI (median, kg/m2, IQR) | 45.8 | (42.0–52.7) | 43.0 | (40.4–46.7) | < 0.001* |
Waist circumference (median, cm, IQR) | 133 | (123–145) | 127 | (120–136) | < 0.001* |
Age (mean, years, SD) | 39.3 | ± 12.5 | 45.6 | ± 10.3 | < 0.001* |
Type 2 diabetes mellitus | 170 | 17.6% | 1,160 | 29.9% | < 0.001* |
Hypertension | 297 | 30.8% | 1,593 | 40.9% | < 0.001* |
Dyslipidaemia | 128 | 13.3% | 902 | 23.1% | < 0.001* |
GERD | 49 | 5.1% | 233 | 6.0% | 0.317 |
OSAS | 200 | 20.7% | 812 | 20.8% | 0.965 |
Musculoskeletal pain | 430 | 44.6% | 2,294 | 58.8% | < 0.001* |
Results
Sleeve gastrectomy
(a) | |||||||
---|---|---|---|---|---|---|---|
Age (n) | 18–24 (n = 135) | 25–34 (n = 257) | 35–44 (n = 211) | 45–54 (n = 226) | 55–64 (n = 124) | 65 + (n = 12) | Overall (n = 965) |
Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | |
Physical functioning | 91.26 ± 13.90 | 90.42 ± 18.33 | 88.39 ± 19.81 | 83.03 ± 20.76 | 75.27 ± 25.79 | 58.33 ± 37.77 | 85.92 ± 20.92 |
Social functioning | 84.68 ± 21.38 | 86.04 ± 21.47 | 87.30 ± 19.74 | 84.03 ± 21.48 | 82.00 ± 23.28 | 77.00 ± 34.12 | 85.03 ± 21.46 |
Physical role limitations | 88.79 ± 26.07 | 87.57 ± 27.46 | 85.97 ± 27.93 | 81.65 ± 32.00 | 79.30 ± 33.30 | 70.83 ± 45.87 | 84.63 ± 29.69 |
Emotional role limitations | 85.37 ± 31.27 | 86.35 ± 30.38 | 90.28 ± 26.63 | 85.49 ± 31.24 | 83.04 ± 31.02 | 83.33 ± 40.82 | 86.42 ± 30.08 |
Mental health | 76.37 ± 17.76 | 78.21 ± 17.53 | 81.29 ± 15.41 | 79.08 ± 18.03 | 80.99 ± 15.50 | 72.67 ± 31.94 | 79.21 ± 17.15 |
Vitality | 61.44 ± 20.74 | 62.91 ± 18.73 | 67.90 ± 17.58 | 67.25 ± 19.69 | 68.60 ± 18.44 | 61.67 ± 32.20 | 65.68 ± 19.20 |
Pain | 82.68 ± 24.76 | 84.39 ± 21.85 | 80.48 ± 26.79 | 75.79 ± 26.33 | 73.16 ± 27.44 | 61.00 ± 39.18 | 79.44 ± 25.72 |
General health perception | 55.68 ± 15.15 | 56.80 ± 15.96 | 56.44 ± 15.90 | 55.42 ± 16.03 | 51.53 ± 18.00 | 51.33 ± 24.45 | 55.48 ± 16.26 |
Health change | 93.68 ± 16.27 | 93.44 ± 14.83 | 92.90 ± 17.74 | 92.49 ± 19.10 | 93.82 ± 13.11 | 95.83 ± 10.21 | 93.18 ± 16.56 |
(b) | |||||||
---|---|---|---|---|---|---|---|
Age (n) | 18–24 (n = 135) | 25–34 (n = 257) | 35–44 (n = 211) | 45–54 (n = 226) | 55–64 (n = 124) | 65 + (n = 12) | Overall (n = 965) |
Delta ± SD | Delta ± SD | Delta ± SD | Delta ± SD | Delta ± SD | Delta ± SD | Delta ± SD | |
Physical functioning | 28.51 ± 19.94 | 30.50 ± 23.68 | 30.81 ± 26.11 | 33.61 ± 24.77 | 33.98 ± 23.26 | 19.17 ± 42.12 | 31.46 ± 24.24 |
Social functioning | 8.56 ± 26.69 | 17.37 ± 29.25 | 15.64 ± 26.54 | 14.57 ± 26.20 | 14.12 ± 25.78 | 29.33 ± 55.09 | 14.85 ± 27.48 |
Physical role limitations | 19.54 ± 41.84 | 28.07 ± 43.76 | 29.03 ± 42.97 | 32.66 ± 45.62 | 27.42 ± 46.63 | 29.17 ± 62.08 | 28.28 ± 44.38 |
Emotional role limitations | 0.78 ± 36.75 | 7.85 ± 40.84 | 6.45 ± 36.14 | 10.60 ± 38.88 | 4.67 ± 42.51 | 17.00 ± 18.62 | 6.99 ± 38.94 |
Mental health | 3.17 ± 17.48 | 10.50 ± 20.20 | 7.77 ± 17.68 | 7.68 ± 17.74 | 6.49 ± 16.02 | 2.00 ± 28.48 | 7.65 ± 18.32 |
Vitality | 8.16 ± 19.96 | 10.61 ± 21.36 | 14.74 ± 21.50 | 18.79 ± 20.83 | 19.09 ± 22.44 | 0.00 ± 28.28 | 14.31 ± 21.64 |
Pain | 13.03 ± 25.40 | 18.66 ± 26.66 | 18.05 ± 29.37 | 17.42 ± 26.64 | 20.12 ± 26.03 | 26.33 ± 42.07 | 17.77 ± 27.17 |
General health perception | 18.94 ± 16.61 | 21.54 ± 17.02 | 19.38 ± 17.73 | 19.54 ± 17.42 | 18.41 ± 17.09 | 15.33 ± 14.40 | 19.76 ± 17.20 |
Health change | 54.02 ± 27.72 | 55.03 ± 29.44 | 51.94 ± 32.30 | 53.61 ± 32.98 | 56.72 ± 30.87 | 70.83 ± 36.80 | 54.22 ± 31.02 |
Roux-en-Y gastric bypass
(a) | |||||||
---|---|---|---|---|---|---|---|
Age (n) | 18–24 (n = 84) | 25–34 (n = 537) | 35–44 (n = 1040) | 45–54 (n = 1,427) | 55–64 (n = 741) | 65 + (n = 70) | Overall (n = 3899) |
Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | |
Physical functioning | 94.42 ± 10.54 | 92.90 ± 13.67 | 91.94 ± 15.58 | 88.19 ± 18.80 | 82.17 ± 22.11 | 84.44 ± 20.23 | 88.75 ± 18.35 |
Social functioning | 88.42 ± 16.77 | 83.89 ± 22.03 | 87.05 ± 21.24 | 85.07 ± 22.61 | 84.12 ± 23.07 | 89.06 ± 20.19 | 85.40 ± 22.14 |
Physical role limitations | 90.42 ± 24.83 | 86.17 ± 29.91 | 87.23 ± 28.79 | 84.45 ± 31.37 | 82.22 ± 31.89 | 87.50 ± 29.44 | 85.18 ± 30.49 |
Emotional role limitations | 88.82 ± 27.28 | 83.14 ± 33.50 | 90.07 ± 26.37 | 86.61 ± 31.17 | 87.60 ± 30.28 | 94.43 ± 20.28 | 87.44 ± 29.96 |
Mental health | 81.93 ± 12.64 | 78.02 ± 17.83 | 81.41 ± 15.96 | 80.37 ± 17.64 | 80.36 ± 17.16 | 85.26 ± 15.90 | 80.45 ± 17.06 |
Vitality | 62.50 ± 20.14 | 63.20 ± 19.89 | 67.19 ± 19.74 | 67.49 ± 20.30 | 68.81 ± 19.77 | 74.54 ± 18.31 | 67.11 ± 20.04 |
Pain | 87.42 ± 20.75 | 82.60 ± 23.44 | 82.76 ± 23.22 | 79.84 ± 24.59 | 76.44 ± 25.89 | 78.56 ± 28.79 | 80.48 ± 24.45 |
General health perception | 57.47 ± 11.38 | 57.71 ± 15.01 | 60.42 ± 14.81 | 60.14 ± 14.84 | 59.44 ± 14.79 | 62.81 ± 15.59 | 59.75 ± 14.82 |
Health change | 95.42 ± 13.41 | 94.17 ± 16.92 | 95.37 ± 15.17 | 94.61 ± 16.13 | 94.47 ± 16.59 | 95.83 ± 15.16 | 94.77 ± 16.01 |
(b) | |||||||
---|---|---|---|---|---|---|---|
Age (n) | 18–24 (n = 84) | 25–34 (n = 537) | 35–44 (n = 1040) | 45–54 (n = 1427) | 55–64 (n = 741) | 65 + (n = 70) | Overall (n = 3899) |
Delta ± SD | Delta ± SD | Delta ± SD | Delta ± SD | Delta ± SD | Delta ± SD | Delta ± SD | |
Physical functioning | 24.17 ± 20.34 | 30.66 ± 22.87 | 31.75 ± 23.31 | 34.54 ± 23.14 | 36.76 ± 24.36 | 41.85 ± 24.73 | 33.61 ± 23.50 |
Social functioning | 8.45 ± 24.03 | 13.03 ± 26.80 | 14.20 ± 28.57 | 13.99 ± 27.51 | 15.88 ± 28.40 | 16.13 ± 29.31 | 14.20 ± 27.84 |
Physical role limitations | 16.25 ± 39.82 | 23.57 ± 43.65 | 27.49 ± 44.97 | 29.19 ± 45.80 | 33.11 ± 47.96 | 35.19 ± 47.71 | 28.57 ± 45.73 |
Emotional role limitations | 4.47 ± 43.26 | − 0.97 ± 39.34 | 6.24 ± 36.86 | 3.60 ± 40.44 | 12.83 ± 45.57 | 9.93 ± 34.10 | 5.56 ± 40.55 |
Mental health | 7.07 ± 13.77 | 7.54 ± 18.36 | 8.44 ± 17.88 | 6.84 ± 18.46 | 7.99 ± 18.36 | 7.26 ± 20.46 | 7.59 ± 18.23 |
Vitality | 3.75 ± 22.71 | 12.47 ± 22.74 | 16.68 ± 23.02 | 16.98 ± 22.39 | 18.38 ± 22.89 | 18.89 ± 22.12 | 16.32 ± 22.82 |
Pain | 11.58 ± 28.36 | 17.95 ± 31.18 | 18.92 ± 27.69 | 20.99 ± 28.07 | 20.98 ± 27.36 | 21.57 ± 33.49 | 19.85 ± 28.42 |
General health perception | 15.47 ± 18.15 | 21.40 ± 18.11 | 22.53 ± 17.34 | 23.53 ± 17.23 | 22.89 ± 16.30 | 23.93 ± 18.13 | 22.70 ± 17.28 |
Health change | 42.50 ± 30.64 | 51.49 ± 30.40 | 55.08 ± 29.28 | 57.62 ± 28.81 | 58.16 ± 29.34 | 57.87 ± 24.68 | 55.91 ± 29.34 |
Overall quality of life
(a) | |||||||
---|---|---|---|---|---|---|---|
Sleeve gastrectomy | Roux-en-Y gastric bypass | Dutch reference group | |||||
n = 965 | n = 3899 | ||||||
Mean ± SD | % | p-value | Mean ± SD | % | p-value | Mean ± SD | |
Physical functioning | 86.02 ± 19.66 | + 3.5 | < 0.001 | 88.76 ± 17.69 | + 6.8* | < 0.001* | 83.09 ± 20.39 |
Social functioning | 85.02 ± 21.32 | − 2.7 | 0.002 | 85.40 ± 22.05 | − 2.2 | < 0.001 | 87.35 ± 19.74 |
Physical role limitations | 84.73 ± 29.21 | + 5.6* | < 0.001* | 85.19 ± 30.36 | + 6.2* | < 0.001* | 80.24 ± 34.84 |
Emotional role limitations | 86.41 ± 29.90 | + 1.9 | 0.128 | 87.43 ± 29.72 | + 3.1 | < 0.001 | 84.79 ± 31.46 |
Mental health | 79.12 ± 17.01 | + 2.8 | < 0.001 | 80.44 ± 16.96 | + 4.5 | < 0.001 | 77.00 ± 18.66 |
Vitality | 65.53 ± 18.98 | − 3.0 | 0.002 | 67.09 ± 19.92 | − 0.7 | 0.241 | 67.59 ± 19.82 |
Pain | 79.55 ± 25.15 | − 2.0 | 0.072 | 80.49 ± 24.27 | − 0.8 | 0.217 | 81.14 ± 24.37 |
General health perception | 55.50 ± 16.11 | − 22.8* | < 0.001* | 59.74 ± 14.76 | − 17.0* | < 0.001* | 71.95 ± 21.60 |
Health change | 93.21 ± 16.29 | + 77.1* | < 0.001* | 94.76 ± 15.97 | + 80.0* | < 0.001* | 52.63 ± 18.50 |
(b) | |||||||
---|---|---|---|---|---|---|---|
Postoperative complication | Unsuccessful %TWL | Dutch reference group | |||||
n = 119 | n = 696 | ||||||
Mean ± SD | % | p-value** | Mean ± SD | % | p-value** | Mean ± SD | |
Physical functioning | 80.58 ± 27.29 | − 3.0 | < 0.001 | 82.42 ± 21.50 | − 0.8 | < 0.001 | 83.09 ± 20.39 |
Social functioning | 77.90 ± 30.93 | − 10.8* | 0.003* | 81.11 ± 23.50 | − 7.4* | 0.001* | 87.35 ± 19.74 |
Physical role limitations | 75.64 ± 39.88 | – 5.7* | 0.005* | 79.43 ± 33.80 | − 1.0 | 0.002 | 80.24 ± 34.84 |
Emotional role limitations | 83.71 ± 33.91 | − 1.27 | 0.292 | 79.16 ± 36.18 | − 6.6* | < 0.001* | 84.79 ± 31.46 |
Mental health | 78.90 ± 18.81 | + 2.5 | 0.500 | 76.38 ± 17.57 | + 0.8 | < 0.001 | 77.00 ± 18.66 |
Vitality | 61.92 ± 22.48 | − 8.4* | 0.027* | 63.47 ± 19.98 | − 6.1* | 0.004* | 67.59 ± 19.82 |
Pain | 70.51 ± 30.66 | − 13.1* | < 0.001* | 76.72 ± 25.51 | − 5.4* | 0.015* | 81.14 ± 24.37 |
General health perception | 55.74 ± 16.02 | − 22.5* | 0.060* | 53.46 ± 16.37 | − 25.7* | < 0.001* | 71.95 ± 21.60 |
Health change | 88.46 ± 23.73 | + 68.1* | 0.001* | 89.72 ± 21.88 | + 70.5* | < 0.001* | 52.63 ± 18.50 |
Complications and total weight loss
SG vs. RYGB
Sleeve gastrectomy | Roux-en-Y gastric bypass | Beta estimate | p-value | |
---|---|---|---|---|
n = 965 | n = 3899 | |||
Delta mean ± SD | Delta mean ± SD | |||
Physical functioning | 31.46 ± 24.24 | 33.61 ± 23.50 | 2.758 | 0.008* |
Social functioning | 14.85 ± 27.48 | 14.20 ± 27.84 | − 0.821 | 0.509 |
Physical role limitations | 28.28 ± 44.38 | 28.57 ± 45.73 | − 1.352 | 0.505 |
Emotional role limitations | 6.99 ± 38.94 | 5.56 ± 40.55 | − 2.650 | 0.141 |
Mental health | 7.65 ± 18.32 | 7.59 ± 18.23 | 0.483 | 0.544 |
Vitality | 14.31 ± 21.64 | 16.32 ± 22.82 | 0.919 | 0.361 |
Pain | 17.77 ± 27.17 | 19.85 ± 28.42 | 1.148 | 0.360 |
General health perception | 19.76 ± 17.20 | 22.70 ± 17.28 | 2.607 | < 0.001* |
Health change | 54.22 ± 31.02 | 55.91 ± 29.34 | − 0.072 | 0.957 |