Analysis of the Lack of Follow-Up of Bariatric Surgery Patients: Experience of a Reference Center

Few studies have evaluated the association between non-clinical and clinical determinants in terms of discontinuing follow-up after bariatric surgery. This cohort study aims to assess these associations. Data were collected from a prospectively maintained database of patients who underwent laparosco...

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Bibliographic Details
Main Authors: Marie Auge, Olivier Dejardin, Benjamin Menahem, Adrien Lee Bion, Véronique Savey, Guy Launoy, Véronique Bouvier, Arnaud Alves
Format: Article
Language:English
Published: MDPI AG 2022-10-01
Series:Journal of Clinical Medicine
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Online Access:https://www.mdpi.com/2077-0383/11/21/6310
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Summary:Few studies have evaluated the association between non-clinical and clinical determinants in terms of discontinuing follow-up after bariatric surgery. This cohort study aims to assess these associations. Data were collected from a prospectively maintained database of patients who underwent laparoscopic bariatric surgery from January 2012 to December 2019. The Cox model was used to assess the influence of preoperative determinants on follow-up interruptions for more than one year. Multilevel logistic regression was used to evaluate the association between clinical factors and post-operative weight loss with the regularity of follow-up. During the study period, 9607 consultations were performed on 1549 patients. The factors associated with a follow-up interruption from more than 365 days included male gender (HR = 1.323; CI = 1.146–1.527; <i>p</i> = 0.001) and more recent years of intervention (HR = 1.043; CI = 1.012–1.076; <i>p</i> = 0.0068). Revisional bariatric surgery was associated with a lower risk of follow-up interruption (HR = 0.753; CI = 0.619–0.916; <i>p</i> = 0.0045). Independent risk factors of an irregular follow up were higher age (HR = 1.01; CI = 1.002–1.017; <i>p</i> = 0.0086); male gender (OR = 1.272; CI = 1.047–1.545; <i>p</i> = 0.0153); and higher %TWL (Total Weight Loss) (OR = 1.040 CI = 1.033–1.048 <i>p</i> < 0.0001). A higher preoperative BMI (OR = 0.985; CI = 0.972–0.998; <i>p</i> = 0.0263) and revisional surgery (OR = 0.707; CI = 0.543–0.922; <i>p</i> = 0.0106) were protective factors of irregularity. This study suggests that the male gender and most recent dates of surgery are the two independent risk factors for follow-up interruption. Older age, male gender, and higher weight loss were all independent risk factors of an irregular follow-up. Revision bariatric surgery is a protective factor against interruption and irregular follow-up with a higher preoperative BMI. Further studies are needed to obtain long-term results in these patients with discontinued follow-ups.
ISSN:2077-0383