Department of Bariatric Surgery, University Hospitals of North Midlands, Stoke-on-Trent, United Kingdom.
Sunderland Royal Hospital, Sunderland, United Kingdom.
Surg Obes Relat Dis. 2017 Nov;13(11):1914-1920. doi: 10.1016/j.soard.2017.08.009. Epub 2017 Aug 12.
Patients often have less than realistic expectations of the weight loss they are likely to achieve after bariatric surgery. It would be useful to have a well-validated prediction tool that could give patients a realistic estimate of their expected weight loss.
To perform a systematic review of the literature to identify existing prediction models and attempt to validate these models.
University hospital, United Kingdom.
A systematic review was performed. All English language studies were included if they used data to create a prediction model for postoperative weight loss after bariatric surgery. These models were then tested on patients undergoing bariatric surgery between January 1, 2013 and December 31, 2014 within our unit.
An initial literature search produced 446 results, of which only 4 were included in the final review. Our study population included 317 patients. Mean preoperative body mass index was 46.1 ± 7.1. For 257 (81.1%) patients, 12-month follow-up was available, and mean body mass index and percentage excess weight loss at 12 months was 33.0 ± 6.7 and 66.1% ± 23.7%, respectively. All 4 of the prediction models significantly overestimated the amount of weight loss achieved by patients. The best performing prediction model in our series produced a correlation coefficient (R) of .61 and an area under the curve of .71 on receiver operating curve analysis.
All prediction models overestimated weight loss after bariatric surgery in our cohort. There is a need to develop better procedures and patient-specific models for better patient counselling.
患者对减重手术后可能达到的减重效果往往抱有不切实际的期望。如果有一种经过良好验证的预测工具，可以让患者对自己的预期减重效果有一个现实的估计，那将是非常有用的。
对文献进行系统回顾，以确定现有的预测模型，并尝试验证这些模型。
英国大学医院。
进行了系统回顾。如果研究使用数据为减重手术后的术后体重减轻创建了预测模型，则纳入所有使用英语发表的研究。然后，在我们的单位内，对 2013 年 1 月 1 日至 2014 年 12 月 31 日期间接受减重手术的患者进行了这些模型的测试。
最初的文献搜索产生了 446 项结果，其中只有 4 项被纳入最终综述。我们的研究人群包括 317 名患者。术前平均体重指数为 46.1 ± 7.1。对于 257 名（81.1%）患者，有 12 个月的随访结果，12 个月时的平均体重指数和超重百分比减轻分别为 33.0 ± 6.7 和 66.1% ± 23.7%。所有 4 种预测模型均显著高估了患者的减重量。在我们的系列研究中表现最好的预测模型产生了 0.61 的相关系数（R）和 0.71 的接收者操作曲线分析下的曲线下面积。
在我们的队列中，所有预测模型都高估了减重手术后的减重效果。需要开发更好的程序和针对患者的模型，以更好地为患者提供咨询。
