Introduction
Methods
Study Design
Setting
Patient Population
Data Source
Variables
Preoperative Weight Change
Outcome Measures
Statistical Analysis
Results
Study Population
Baseline Characteristics
Variable | Value |
---|---|
Age, years | 44.1 ± 11.4 |
Female sex | 1517 (78.6) |
Bariatric surgery type | |
Roux-en-Y gastric bypass | 1229 (63.7) |
Sleeve gastrectomy | 446 (23.1) |
Banded Roux-en-Y gastric bypass | 253 (13.1) |
ASA score | |
2 | 1040 (53.9) |
3 | 866 (44.9) |
4 | 15 (0.8) |
Associated medical problems | |
Hypertension | 663 (34.4) |
Type 2 diabetes | 394 (20.4) |
Dyslipidemia | 383 (19.9) |
Obstructive sleep apnea syndrome | 338 (17.5) |
BMI, kg/m2 | |
Start of preoperative care program | 43.7 (±5.6) |
Day of surgery | 43.1 (±5.6) |
Comparison Between Groups
Group I Weight loss (>5 kg) | Group II Weight loss (3–5 kg) | Group III Weight loss (1–3 kg) | Group IV Stable weight (−1 to +1 kg) | Group V Weight gain (>1 kg) | p-value | |
---|---|---|---|---|---|---|
Number of patients | 296 | 263 | 447 | 623 | 299 | |
Age, years | 44.8 ± 10.4 | 45.0 ± 11.4 | 44.9 ± 11.1 | 43.6 ± 11.8 | 42.6 ± 12.0 | 0.02 |
Female | 222 (75.0) | 205 (77.9) | 370 (82.8) | 496 (79.6) | 224 (74.9) | 0.04* |
Bariatric surgery type | <0.01* | |||||
Roux-en-Y gastric bypass | 141 (47.6) | 158 (60.1) | 314 (70.2) | 437 (70.1) | 179 (59.9) | |
Sleeve gastrectomy | 38 (12.8) | 59 (17.5) | 96 (21.5) | 152 (24.4) | 101 (33.8) | |
Banded Roux-en-Y gastric bypass | 117 (39.5) | 46 (22.4) | 37 (8.3) | 34 (5.5) | 19 (6.4) | |
ASA score | <0.01* | |||||
2 | 142 (48.0) | 110 (41.8) | 250 (55.9) | 373 (55.9) | 165 (55.2) | |
3 | 147 (49.7) | 151 (47.4) | 193 (43.2) | 242 (38.8) | 133 (44.5) | |
4 | 7 (2.7) | 1 (0.4) | 2 (0.4) | 4 (0.6) | 1 (0.3) | |
Associated medical problems | ||||||
Hypertension | 99 (33.4) | 96 (36.5) | 154 (34.5) | 215 (34.5) | 99 (33.1) | 0.93 |
Type 2 diabetes | 46 (15.5) | 60 (22.8) | 95 (21.3) | 143 (23.0) | 50 (16.7) | 0.03* |
Dyslipidemia | 60 (20.3) | 56 (21.3) | 93 (20.8) | 116 (18.6) | 58 (19.4) | 0.87 |
OSAS | 58 (19.6) | 52 (19.8) | 80 (17.9) | 96 (15.4) | 52 (17.4) | 0.44 |
BMI, kg/m2 | ||||||
Start preoperative care program | 44.6 ± 6.8 | 43.9 ± 5.5 | 43.2 ± 5.1 | 43.5 ± 5.2 | 44.0 ± 5.6 | 0.01* |
Day of surgery | 42.0 ± 6.6 | 42.5 ± 5.5 | 42.5 ± 5.1 | 43.5 ± 5.2 | 45.0 ± 5.7 | <0.01* |
Preoperative weight change | ||||||
Weight change before surgery, kg | −6.8 [−5.9 to −8.5] | -4.0 ± 0.6 | −2.0 ± 0.6 | 0.0 ± 0.6 | 2.2 [1.5–3.7] | <0.01* |
Weight change before surgery, %TWL | −5.8 [−5.0 to −7.2] | −3.3 ± 0.7 | −1.6 ± 0.5 | 0.0 ± 0.5 | 1.7 [1.2–2.8] | <0.01* |
Weight and Preoperative Weight Change
Total Weight Loss
Postoperative Weight Loss
12 months | 24 months | 36 months | |||||||
---|---|---|---|---|---|---|---|---|---|
β | 95% CI | p-value | β | 95% CI | P-value | β | 95% CI | p-value | |
Group I Weight loss >5 kg | |||||||||
Model 1a | −2.42 | −3.55 to −1.30 | <0.01 | −3.05 | −4.20 to −1.89 | <0.01 | −3.71 | −4.91 to −2.52 | <0.01 |
Model 2b | −2.76 | −3.86 to −1.67 | <0.01 | −3.39 | −4.51 to −2.27 | <0.01 | −4.07 | −5.23 to −2.91 | <0.01 |
Model 3c | −2.76 | −3.87 to −1.64 | <0.01 | −3.36 | −4.50 to −2.22 | <0.01 | −4.03 | −5.21 to −2.85 | <0.01 |
Group II Weight loss 3–5 kg | |||||||||
Model 1a | −1.68 | −2.84 to −0.52 | 0.01 | −2.92 | −4.12 to −1.71 | <0.01 | −2.43 | −3.67 to −1.19 | <0.01 |
Model 2b | −1.96 | −3.01 to −0.84 | <0.01 | −3.20 | −4.37 to −2.03 | <0.01 | −2.72 | −3.93 to −1.52 | <0.01 |
Model 3c | −1.60 | −2.70 to −0.49 | 0.01 | −2.83 | −3.99 to −1.68 | <0.01 | −2.35 | −3.54 to −1.16 | <0.01 |
Group III Weight loss 1–3 kg | |||||||||
Model 1a | −1.07 | −2.10 to −0.05 | 0.04 | −1.44 | −2.50 to −0.39 | 0.01 | −2.09 | −3.18 to −0.99 | <0.01 |
Model 2b | −1.26 | −2.25 to −0.26 | 0.01 | −1.62 | −2.65 to −0.60 | <0.01 | −2.27 | −3.34 to −1.21 | <0.01 |
Model 3c | −1.33 | −2.29 to −0.37 | 0.01 | −1.69 | −2.68 to −0.69 | <0.01 | −2.32 | −3.35 to −1.29 | <0.01 |
Group IV Stable weight | |||||||||
Model 1a | −0.94 | −1.90–0.03 | 0.06 | −1.69 | −2.69 to −0.69 | <0.01 | −1.97 | −3.01 to −0.94 | <0.01 |
Model 2b | −0.92 | −1.85–0.01 | 0.05 | −1.66 | −2.63 to −0.70 | <0.01 | −1.96 | −2.96 to −0.96 | <0.01 |
Model 3c | −1.00 | −1.90 to −0.09 | 0.03 | −1.73 | −2.67 to −0.80 | <0.01 | −2.02 | −3.00 to −1.05 | <0.01 |