Department of Gastro-Intestinal Surgery, Amsterdam University Medical Center, location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, the Netherlands.
Obes Surg. 2021 Aug;31(8):3606-3614. doi: 10.1007/s11695-021-05450-6. Epub 2021 May 8.
The importance of follow-up (FU) for midterm weight loss (WL) after bariatric surgery is controversial. Compliance to this FU remains challenging. Several risk factors for loss to FU (LtFU) have been mentioned. The aim was therefore to evaluate the association between WL and LtFU 3 to 5 years postoperatively and to identify risk factors for LtFU.
A single-center cross-sectional study in the Netherlands. Between June and October 2018, patients scheduled for a 3-, 4-, or 5-year FU appointment were included into two groups: compliant (to their scheduled appointment and overall maximally 1 missed appointment) and non-compliant (missed the scheduled appointment and at least 1 overall). Baseline, surgical, and FU characteristics were collected and a questionnaire concerning socio-economic factors.
In total, 217 patients in the compliant group and 181 in the non-compliant group were included with a median body mass index at baseline of 42.0 and 42.9 respectively. Eighty-eight percent underwent a laparoscopic Roux-en-Y gastric bypass. The median percentage total weight loss for the compliant and non-compliant groups was 30.7% versus 28.9% at 3, 29.3% versus 30.2% at 4, and 29.6% versus 29.9% at 5 years respectively, all p>0.05. Age, persistent comorbidities and vitamin deficiencies, a yearly salary <20,000 euro, no health insurance coverage, and not understanding the importance of FU were risk factors for LtFU.
Three to 5 years postoperatively, there is no association between LtFU and WL. The compliant group demonstrated more comorbidities and vitamin deficiencies. Younger age, not understanding the importance of FU, and financial challenges were risk factors for LtFU.
减重手术后中期减重（WL）随访（FU）的重要性存在争议。遵守该 FU 仍然具有挑战性。已经提到了几种 FU 失访（LtFU）的风险因素。因此，本研究旨在评估术后 3 至 5 年 WL 与 LtFU 之间的相关性，并确定 LtFU 的风险因素。
这是荷兰的一项单中心横断面研究。2018 年 6 月至 10 月，将计划进行 3、4 或 5 年 FU 预约的患者纳入两组：符合（按时预约且最多错过 1 次预约）和不符合（错过预约且至少错过 1 次预约）。收集了基线、手术和 FU 特征，并进行了一项关于社会经济因素的问卷调查。
共纳入 217 名符合组患者和 181 名不符合组患者，基线时的中位体重指数分别为 42.0 和 42.9。88%的患者接受了腹腔镜 Roux-en-Y 胃旁路手术。符合组和不符合组的中位总体重减轻百分比分别为 3 年后 30.7%比 28.9%，4 年后 29.3%比 30.2%，5 年后 29.6%比 29.9%，所有差异均无统计学意义（均 P>0.05）。年龄、持续性合并症和维生素缺乏、年薪<20,000 欧元、无健康保险覆盖和不了解 FU 的重要性是 LtFU 的风险因素。
术后 3 至 5 年，LtFU 与 WL 之间无关联。符合组表现出更多的合并症和维生素缺乏。年轻、不了解 FU 的重要性和经济挑战是 LtFU 的风险因素。
