Predictors of Success After Laparoscopic Sleeve Gastrectomy: An Analysis of Socioeconomic and Demographic Factors

Ameer Gomberawalla, MD, Thomas Willson, MD, Kimberley Mahoney, RN, Alfonso Torquati, MD, FACS, Rami Lutfi, MD, FACS

Saint Joseph Hospital, Chicago Institute of Advanced Bariatrics

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is gaining more popularity and has become the fastest growing bariatric operation at this time. However,it has been difficult to predict optimal outcomes. Our study is aimed at identifying preoperative factors that are predictive of successful weight loss after LSG.

METHODS and PROCEDURES: A total of 100 consecutive patients were enrolled over 36 months. Socioeconomic and demographic factors were prospectively collected for patients undergoing LSG. All procedures were performed by a single surgeon in a single teaching institution. Primary endpoint was percent of excess weight loss (EWL) at one year follow up. The cutoff point to define inadequate weight loss was set as mean 1-year EWL -1 SD. Logistic regression was used in both univariate and multivariate analysis to identify independent preoperative factors associated with successful weight loss.

RESULTS: Mean preoperative body mass index (BMI) was 48.72. Mean EWL at one year was 65.7% ± 23.5; therefore, adequate weight loss was defined as EWL > 42.2%. According to this cutoff, 82 patients (82%) achieved successful weight loss one year after LSG. On univariate analysis, higher preoperative BMI, being a current or past smoker, unemployment, and a lower level of education were associated with a higher likelihood of failure. Age, sex, marital status, number of children, and history of binge eating or depression were not correlated with weight loss outcome. Preoperative BMI remained an independent predictor of success (adequate EWL at 1 year) in the multivariate logistic regression model after adjusting for covariates. Average BMI for the successful group was 47.5 versus 53.5 for the inadequate EWL group. A unit increase in BMI is associated with 1.1 increase in the log hazard rate of having an inadequate EWL (OR 1.1; 95% CI: 1-1.1, p = 0.008).

CONCLUSIONS: Successful weight loss was achieved in more than 82% of patients undergoing LSG. Patients with BMI lower than 50 have the highest odds to achieve such success and therefore they should represent the ideal target population for LSG.

Session: Poster Presentation

Program Number: P433

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