Bariatric Medicine Institute, Salt Lake City, Utah.
Eviva Bariatrics, Shoreline, Washington.
Surg Obes Relat Dis. 2017 Aug;13(8):1266-1270. doi: 10.1016/j.soard.2017.03.016. Epub 2017 Mar 23.
Despite being the most common surgery in the United States, little is known about predicting weight loss success and failure with sleeve gastrectomy (SG). Papers that have been published are inconclusive. We decided to use multivariate analysis from 2 practices to design a model to predict weight loss outcomes using data widely available to any surgical practice at 3 months to determine weight loss outcomes at 1 year.
Two private practices in the United States.
A retrospective review of 613 patients from 2 bariatric institutions were included in this study. Co-morbidities and other preoperative characteristics were gathered, and %EWL was calculated for 1, 3, and 12 months. Excess weight loss (%EWL)<55% at 1 year was defined as weight loss failure. Multiple variate analysis was used to find factors that affect %EWL at 12 months.
Preoperative sleep apnea, preoperative diabetes, %EWL at 1 month, and %EWL at 3 months all affect %EWL at 1 year. The positive predictive value and negative predictive value of our model was 72% and 91%, respectively. Sensitivity and specificity were 71% and 91%, respectively.
One-year results of the SG can be predicted by diabetes, sleep apnea, and weight loss velocity at 3 months postoperatively. This can help surgeons direct surgical or medical interventions for patients at 3 months rather than at 1 year or beyond.
尽管在美国袖状胃切除术(SG)是最常见的手术,但对于预测 SG 减肥成功或失败的方法却知之甚少。已发表的相关论文结果并不一致。我们决定使用两个实践中的多元分析来设计一个模型,以便使用任何外科手术在 3 个月时广泛获得的数据来预测 1 年时的减肥结果,从而确定减肥结果。
美国的两家私人诊所。
本研究纳入了来自 2 家减肥机构的 613 例患者的回顾性研究。收集了合并症和其他术前特征,并计算了 1、3 和 12 个月的体重减轻百分比(%EWL)。1 年内体重减轻不足 55%定义为减肥失败。使用多元分析来寻找影响 12 个月时%EWL 的因素。
术前睡眠呼吸暂停、术前糖尿病、1 个月时的 EWL%和 3 个月时的 EWL%均影响 1 年时的 EWL%。我们模型的阳性预测值和阴性预测值分别为 72%和 91%。灵敏度和特异性分别为 71%和 91%。
SG 的 1 年结果可通过糖尿病、睡眠呼吸暂停和术后 3 个月的体重减轻速度预测。这可以帮助外科医生在 3 个月而不是 1 年或更晚的时候为患者提供手术或医疗干预。