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The effect of close postoperative follow-up on co-morbidity improvement after bariatric surgery

2017; Elsevier BV; Volume: 13; Issue: 8 Linguagem: Inglês

10.1016/j.soard.2017.03.024

1878-7533

Andrea Schwoerer, Kevin R. Kasten, Adam C. Celio, Walter J. Pories, Konstantinos Spaniolas,

Gastric Cancer Management and Outcomes

Abstract Background Patients undergoing gastric bypass (RYGB) surgery require follow-up for efficacy assessment, early detection of postoperative complications, and also for management of co-morbid conditions. Recent literature shows support for improved long-term weight loss with close patient follow-up. However, attrition rates after RYGB have been reported as high as 50%. Objective The objective of this study was to assess the relationship between complete follow-up and improvement or remission of co-morbid conditions at 12 months after surgery. Setting University Hospital, United States. Methods Using the Bariatric Outcomes Longitudinal Database (BOLD) data set, patients with 12-month follow-up after RYGB were identified. Patients with complete follow-up were compared with patients who had missed either or both of their 3- and 6-month visits. Improvement and remission of type 2 diabetes, hypertension, and dyslipidemia were evaluated at 12-month postoperatively. Results 46,381 patients (30.6% of all RYGB patients) were identified that had follow-up with minimum 12-month data. Complete follow-up was recorded for 75.6% of this group with 12-month data. Of the 18,629 patients with type 2 diabetes at baseline, 13,498 (72.4%) and 11,287 (60.6%) had improvement and remission, respectively, at 12 months. Improvement in hypertension and dyslipidemia was noted in 17,808 (62.8%) and 11,602 (55.2%) of patients, while 13,024 (45.9%) and 9119 (43.4%) had hypertension and dyslipidemia remission, respectively. After adjusting for baseline characteristics, complete follow-up in the first year after RYGB was independently associated with a higher rate of improvement or remission of co-morbid conditions. Conclusion Complete postoperative follow-up resulted in a higher rate of co-morbidity improvement and remission compared with incomplete postoperative care. Patients and practices should strive to achieve complete and long-term follow-up after RYGB surgery.