Livhits Masha, Mercado Cheryl, Yermilov Irina, Parikh Janak A, Dutson Erik, Mehran Amir, Ko Clifford Y, Gibbons Melinda Maggard
Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, 10833 LeConte Avenue, 72 215 CHS, Los Angeles, CA 90095, USA.
Am Surg. 2010 Oct;76(10):1139-42.
Patients undergoing bariatric surgery lose substantial weight (> or = 50% excess weight loss [EWL]), but an estimated 20 per cent fail to achieve this goal. Our objective was to identify behavioral predictors of weight loss after laparoscopic Roux-en-Y gastric bypass. We retrospectively surveyed 148 patients using validated instruments for factors predictive of weight loss. Success was defined as > or =50 per cent EWL and failure as <50 per cent EWL. Mean follow-up after laparoscopic Roux-en-Y gastric bypass was 40.1 +/- 15.3 months, with 52.7 per cent of patients achieving successful weight loss. After controlling for age, gender, and preoperative body mass index, predictors of successful weight loss included surgeon follow-up (odds ratio [OR] 8.2, P < 0.01), attendance of postoperative support groups (OR 3.7, P = 0.02), physical activity (OR 3.5, P < 0.01), single or divorced marital status (OR 3.2, P = 0.03), self-esteem (OR 0.3, P = 0.02), and binge eating (OR 0.9, P < 0.01). These factors should be addressed in prospective studies of weight loss after bariatric surgery, as they may identify patients at risk for weight loss failure who may benefit from early tailored interventions.
接受减肥手术的患者体重显著下降(超重减轻≥50%[EWL]),但估计有20%的患者未能达到这一目标。我们的目的是确定腹腔镜Roux-en-Y胃旁路术后体重减轻的行为预测因素。我们使用经过验证的工具对148例患者进行了回顾性调查,以了解体重减轻的预测因素。成功定义为EWL≥50%,失败定义为EWL<50%。腹腔镜Roux-en-Y胃旁路术后的平均随访时间为40.1±15.3个月,52.7%的患者实现了成功减重。在控制了年龄、性别和术前体重指数后,成功减重的预测因素包括外科医生的随访(优势比[OR]8.2,P<0.01)、参加术后支持小组(OR 3.7,P=0.02)、体育活动(OR 3.5,P<0.01)、单身或离异婚姻状况(OR 3.2,P=0.03)、自尊(OR 0.3,P=0.02)和暴饮暴食(OR 0.9,P<0.01)。这些因素应在减肥手术后体重减轻的前瞻性研究中加以探讨,因为它们可能识别出有减重失败风险的患者,这些患者可能从早期的针对性干预中获益。