Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94000, Créteil, France.
INSERM IMRB U955, Université Paris-Est Créteil, Créteil, France.
Obes Surg. 2021 May;31(5):1979-1985. doi: 10.1007/s11695-020-05186-9. Epub 2021 Jan 11.
Follow-up is a cornerstone of the success of bariatric surgery. However, adherence to monitoring decreases over time. The reasons for non-compliance with follow-up still remain unclear.
This is a retrospective, single-center, cohort study, including all patients undergoing bariatric surgery between 2014 and 2017. Patients lost to follow-up were called back and questioned about the reasons of non-adherence. Patients followed and lost to follow-up were compared in terms of weight loss.
Overall, 29.7% of patients were lost to follow-up. After a callback, we obtained information on 89.9% of patients. The first reason of non-attendance was considering follow-up as unnecessary (29.5%). Almost a quarter of patients (24%) discontinued follow-up due to geographic distance, while 23.3%, 18.6%, and 14.0% of patients explained the lack of follow-up due to family, professional, or health problems. Only 7.0% declared to renounce to follow-up because of poor weight loss. Percentage of excess weight loss at 3 and 5 years after surgery was respectively 73.6% and 81.2% in attendant patients, and 70.7% and 68.4% in non-adherent patients (p = ns). Despite a greater weight loss in the group of patients regularly followed, the difference with patients lost to follow-up remained not significant in multivariate analysis.
Follow-up is of crucial importance in the management of bariatric patients. Follow-up disruption is associated to individual patient choice and external constraints. In order to improve the quality of long-term care, care providers will probably need to adapt to these constraints, diversifying the offer of care.
随访是减重手术成功的基石。然而，随着时间的推移，监测的依从性会下降。不遵守随访的原因仍不清楚。
这是一项回顾性、单中心、队列研究，纳入了 2014 年至 2017 年间接受减重手术的所有患者。对失去随访的患者进行了召回，并询问了不依从的原因。对随访和失访的患者进行了体重减轻方面的比较。
总体而言，29.7%的患者失去随访。在召回后，我们获得了 89.9%患者的信息。不就诊的首要原因是认为随访没有必要（29.5%）。近四分之一的患者（24%）因地理距离而停止随访，而 23.3%、18.6%和 14.0%的患者则因家庭、职业或健康问题而无法随访。只有 7.0%的患者因体重减轻不佳而宣布放弃随访。在术后 3 年和 5 年时，在就诊患者中分别有 73.6%和 81.2%的患者达到了超重体重减轻的目标，而在未就诊患者中分别为 70.7%和 68.4%（p = ns）。尽管定期随访的患者体重减轻更多，但在多变量分析中，与失访患者的差异仍不显著。
随访对管理肥胖患者至关重要。随访中断与患者个体选择和外部限制有关。为了提高长期护理质量，护理提供者可能需要适应这些限制，使护理多样化。
