Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
Surg Obes Relat Dis. 2022 Apr;18(4):538-545. doi: 10.1016/j.soard.2021.11.017. Epub 2021 Nov 22.
Long-term durability of weight loss is a prerequisite for a greater acceptance of bariatric surgery.
To examine long-term weight trajectory in patients undergoing Roux-en-Y gastric bypass (RYGB) and determine factors predicting long-term follow-up and weight outcomes.
University hospital.
A retrospective cohort of adults who underwent RYGB during 1997-2010 were identified and followed until 2017. Predictors for attendance at periodic follow-up visits, reduction in body mass index (BMI), and percent excess BMI lost were determined using multivariable logistic regression and linear mixed-effects models. The latter was used to predict long-term weight outcomes for a typical patient.
The study included 1104 patients with a mean age of 45.5 (standard deviation [SD] 9.9) years and a preoperative BMI of 54.7 (SD 10.9) kg/m. Follow-up data were available for 92.8% of the patients after 1 year, 50.0% after 5 years, and 35.2% after 10 years post-surgery. Black patients, compared with White patients, were less likely to attend follow-up visits. Attendance at follow-up visits at least every other year was not associated with larger weight loss, but higher preoperative BMI, being White (versus Black), and female sex were. Predicted BMI reduction for a typical patient, a 45-year-old White female with a preoperative BMI of 54.7 kg/m and private health insurance, undergoing laparoscopic RYGB in 2004, was 18.3 (standard error [SE] .36) kg/m at year 5 and 17.6 (SE .49) kg/m at year 10.
RYGB results in clinically significant and durable weight loss. Attendance at periodic follow-up visits does not appear to be associated with long-term weight loss outcomes. Future work should focus on strategies to remove barriers to post-operative care.
减肥的长期效果是人们接受减重手术的一个前提条件。
检查接受 Roux-en-Y 胃旁路术（RYGB）的患者的长期体重轨迹，并确定预测长期随访和体重结果的因素。
大学医院。
确定了 1997 年至 2010 年间接受 RYGB 的成年人的回顾性队列，并随访至 2017 年。使用多变量逻辑回归和线性混合效应模型确定参加定期随访、体重指数（BMI）降低和 BMI 多余部分丢失的预测因素。后者用于预测典型患者的长期体重结果。
该研究纳入了 1104 名平均年龄为 45.5（标准差[SD]9.9）岁和术前 BMI 为 54.7（SD 10.9）kg/m2的患者。术后 1 年有 92.8%的患者可获得随访数据，5 年时为 50.0%，10 年时为 35.2%。与白人患者相比，黑人患者参加随访的可能性较低。每年至少参加一次随访与更大的体重减轻无关，但术前 BMI 较高、为白人（而非黑人）和女性则与随访有关。对于一个典型患者，一个 45 岁、术前 BMI 为 54.7kg/m2、有私人医疗保险的白人女性，如果在 2004 年接受腹腔镜 RYGB，那么在术后 5 年时预计 BMI 可降低 18.3（标准误差[SE].36）kg/m2，在术后 10 年时可降低 17.6（SE.49）kg/m2。
RYGB 可带来显著且持久的体重减轻。定期随访与长期体重减轻结果似乎无关。未来的工作应侧重于制定策略，以消除术后护理的障碍。
