Pontifical Catholic University of Paraná, Curitiba, Brazil.
Surgery Department, Cevip-Paraná Laparoscopy Center, Curitiba, Brazil.
Obes Surg. 2018 May;28(5):1335-1341. doi: 10.1007/s11695-017-3011-0.
This is a retrospective review of 204 patients who underwent bariatric surgery. The impact of weight regain (WR), pre-operative comorbidities and BMI values on the recurrence of comorbidities was evaluated, and an equation was elaborated to estimate BMI at 5 years of bariatric surgery.
Pre-operative data, after 1 year and after 5 years, was collected from the medical records. Descriptive analyses and bivariate hypothesis tests were performed first, and then, a generalised linear regression model with Tweedie distribution was adjusted. The hit rate and the Kendall coefficient of concordance (Kendall's W) of the equation were calculated. At the end, the Mann-Whitney test was performed between the BMI, WR and the presence of comorbidities, after a post-operative period of 5 years.
The adjustment of the model resulted in an equation that estimates the mean value of BMI 5 years after surgery. The hit rate was 82.35% and the value of Kendall's W was 0.85 for the equation. It was found that patients with comorbidities presented a higher median WR (10.13%) and a higher mean BMI (30.09 kg/m) 5 years after the surgery.
It is concluded that the equation is useful for estimating the mean BMI at 5 years of surgery and that patients with low pre-operative HDL and folic acid levels, with depression and/or anxiety and a higher BMI, have a higher BMI at 5 years of surgery and higher incidence of comorbid return and dissatisfaction with post-operative results.
这是对 204 例接受减重手术患者的回顾性研究。评估了体重反弹（WR）、术前合并症和 BMI 值对合并症复发的影响，并阐述了一个估计减重手术后 5 年 BMI 的方程。
从病历中收集术前、术后 1 年和术后 5 年的数据。首先进行描述性分析和双变量假设检验，然后调整具有 Tweedie 分布的广义线性回归模型。计算方程的命中率和肯德尔一致性系数（Kendall's W）。最后，在手术后 5 年，对 BMI、WR 和合并症的存在进行了曼-惠特尼检验。
模型的调整产生了一个估计术后 5 年 BMI 平均值的方程。该方程的命中率为 82.35%，肯德尔一致性系数（Kendall's W）为 0.85。结果发现，有合并症的患者在手术后 5 年内体重反弹中位数（10.13%）更高，平均 BMI 更高（30.09kg/m）。
该方程可用于估计术后 5 年的平均 BMI，术前 HDL 和叶酸水平较低、患有抑郁和/或焦虑症以及 BMI 较高的患者，在术后 5 年内 BMI 更高，合并症复发和对术后结果不满意的发生率更高。
