Montréal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Québec, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Québec, Canada.
Montréal Behavioural Medicine Centre (MBMC), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Québec, Canada; Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada.
Surg Obes Relat Dis. 2024 Dec;20(12):1297-1305. doi: 10.1016/j.soard.2024.08.029. Epub 2024 Aug 30.
Prioritizing patients for metabolic and bariatric surgery (MBS) based on their potential postoperative benefits is essential.
To examine changes in quality of life (QoL) during the initial postoperative year among patients with diverse eligibility statuses and determine which group experiences greater benefits.
Center intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de- Montréal (CIUSSS-NIM), Canada.
We categorized patients into 3 groups based on obesity class and the presence of comorbidities: Group 1 (obesity class II without comorbidities, n = 28); Group 2 (obesity class II with comorbidities, n = 36); and Group 3 (obesity class III, n = 460). QoL (Short-Form QoL questionnaire [SF-12]) and anthropometrics were measured at 6 months before, and 6 and 12 months after surgery.
Repeated measures mixed models revealed a significant main effect of time (P < .001) and an interaction between time and group for the physical component of QoL (P = .007). These indicated consistent improvements across time in all groups, with the greatest benefits seen in Group 3 relative to Group 1. There were no interactions between time and group for the mental components of QoL (P = .402). There were significant interaction effects for weight and BMI (P's < .001), with Group 3 losing more weight than Groups 1 or 2.
All groups that underwent MBS had improvements in the physical aspects of QoL and weight over time, even those who have traditionally not be considered eligible for MBS (i.e., Group 1). This provides a starting point to explore the importance of not excluding patients due to their weight and comorbidity status and setting comprehensive eligibility criteria encompassing all patients who might benefit from MBS, beyond just weight loss.
根据患者术后潜在获益对代谢和减重手术（MBS）患者进行优先排序至关重要。
本研究旨在观察不同纳入标准患者在术后初始 1 年内生活质量（QoL）的变化，并确定获益更大的患者群体。
加拿大蒙特利尔岛北岸综合大学健康与社会服务中心（CIUSSS-NIM）。
我们根据肥胖程度和合并症的存在将患者分为 3 组：第 1 组（肥胖 II 级无合并症，n = 28）；第 2 组（肥胖 II 级合并症，n = 36）；第 3 组（肥胖 III 级，n = 460）。在手术前 6 个月、术后 6 个月和 12 个月分别测量 QoL（SF-12 短式健康调查问卷）和人体测量学指标。
重复测量混合模型显示，身体成分 QoL 的时间主效应（P <.001）和时间与组之间的交互作用（P =.007）具有统计学意义。这表明所有组的 QoL 在时间上均持续改善，且第 3 组相对于第 1 组获益最大。精神成分 QoL 的时间与组之间无交互作用（P =.402）。体重和 BMI 存在显著的交互作用（P 值均<.001），第 3 组比第 1 组或第 2 组减重更多。
接受 MBS 的所有患者在体重和 BMI 方面均随时间改善，且无论患者是否有资格接受 MBS（即第 1 组），其 QoL 的身体方面也有所改善。这为探索不排除因体重和合并症而不具备手术资格的患者，并制定全面的纳入标准以涵盖所有可能从 MBS 中获益的患者，而不仅仅是减重患者，提供了起点。
