Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois Chicago, 840 S. Wood Street, Suite 435E, Chicago, IL, 60612, USA.
Department of Surgery, Duke University, Durham, NC, 27710, USA.
Obes Surg. 2024 Oct;34(10):3848-3856. doi: 10.1007/s11695-024-07470-4. Epub 2024 Aug 28.
The success of metabolic and bariatric surgery (MBS) is impacted by significant pre-surgical attrition rates and poor postoperative follow-up. This study focused on geographic variations in attrition rates and surgical outcomes for MBS practice for which the patient population is drawn from nine Chicago neighborhoods, to examine whether suboptimal weight loss or reduced adherence to the program varied across neighborhoods.
Patients who presented for their initial MBS consultation at the University of Illinois (UI) Health's program between January 2019 and December 2020 were identified from electronic medical records. Demographic and medical information was extracted, along with postoperative weight at 3, 6, and 12 months after surgery. The Chicago area was divided into nine geographic regions. The outcomes of interest were preoperative attrition rate, postoperative compliance to follow-up appointments, and postoperative weight loss for each group and by residential neighborhood.
A total of 1202 patients were included in this analysis, of whom 423 (35%) underwent surgery and 780 did not, representing a pre-surgical attrition rate of 64.9%. Age, sex, and race/ethnic distribution varied markedly across geographic regions. Postoperative weight loss varied significantly in neighborhoods with higher proportions of residents from racial/ethnic minority backgrounds. Preoperative attrition and postoperative compliance did not differ across geographic regions.
Patients' residential neighborhoods may influence weight loss after MBS. Preoperative and postoperative compliance did not vary by residential neighborhood.
代谢和减重手术（MBS）的成功受到术前大量流失率和术后随访不佳的影响。本研究专注于 MBS 实践的地理差异，研究人群来自芝加哥的九个社区，以检验超重患者减肥效果不理想或对项目的依从性降低是否因社区而异。
从电子病历中确定了 2019 年 1 月至 2020 年 12 月期间在伊利诺伊大学健康分校 MBS 项目就诊的患者。提取人口统计学和医疗信息，以及术后 3、6 和 12 个月的体重。将芝加哥地区分为九个地理区域。感兴趣的结果是每个组以及按居住社区划分的术前流失率、术后随访预约的依从性和术后体重减轻。
共纳入 1202 例患者，其中 423 例（35%）接受了手术，780 例未接受手术，术前流失率为 64.9%。不同地理区域的年龄、性别和种族/民族分布差异显著。体重减轻在种族/民族背景居民比例较高的社区中差异显著。术前流失和术后依从性在不同地理区域没有差异。
患者的居住社区可能会影响 MBS 后的体重减轻。术前和术后的依从性不因居住社区而异。
