Anthony Carden, MIS, Fellow, Dan Eisenberg, Director of Bariatric Surgery. VA Palo Alto
Introduction: Roux-en-Y gastric bypass (RYGB) is the criterion standard operation for weight loss. Low socioeconomic status is common in the Veteran population undergoing bariatric surgery, but it is not known whether socioeconomic status correlates with long-term weight loss success after RYGB. According to Covered California income guidelines, an individual’s income less than $47,520 per year qualifies for government assistance. We hypothesize that low socioeconomic status correlates with lesser excess weight loss after gastric bypass.
Methods: We performed a retrospective review of patients undergoing RYGB at a single Veterans Affairs (VA) hospital. Patients who did not have weight data in the VA electronic health record for at least 10 years were considered lost to follow-up and were excluded. Estimated household income was determined using zip codes of patient residences matched to publicly available 2010 US census data. Google Maps online map software was used to obtain direct radial distances from the patient’s home to the primary hospital.
Results: Of 108 patients who underwent RYGB between May 2001 and June 2007, the 10-year mortality was 14.8% (n=16) and nine individuals were lost to follow-up (follow-up rate of 91.7%). Of the remaining 83 patients, 79.5% (n=66) were male with a mean age of 51 years (range 28 – 65). Mean preoperative body mass index (BMI) was 45.8 kg/m2 (range 30.4 – 66.7 kg/m2). Overall percent excess body mass index lost (%EBMIL) was 57.8% at 10 years. Estimated mean income ranged from $25,934 to $127,684 (mean $57,552), and did not significantly correlate to %EBMIL (r=0.059). Furthermore, there were 36 patients (43.4%) who lived in areas that fell below the California cut-off for government assistance. The mean %EBMIL in these patients was not significantly different from the patients in higher income brackets (53.9% vs. 60.8, respectively; p = 0.29). Mean distance of the patient’s home from the primary hospital was 391 miles (range 4.3 to 2478 miles), which did not correlate to %EBMIL (p=0.018).
Conclusion: Long-term weight loss is preserved 10 years after RYGB. Veterans receiving bariatric surgery at our institution reside a large distance from the hospital, and nearly half have an estimated income that would qualify for government assistance. Yet, weight loss success of RYGB is independent of socioeconomic status or distance from the bariatric center.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87985
Program Number: S025
Presentation Session: Bariatrics 1 Session
Presentation Type: Podium