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Bringing Patient Choice to Bariatric Surgery: The Predictive Power of Pre-Operative Markers for Single Anastomosis Duodenal Switch

Samuel Cottam, Daniel Cottam, MD, Austin Cottam, BS, Hinali Zaveri, MD, Amit Surve, MD, Christina Richards, MD, FACS, Walter Medlin, MD. Bariatric Medicine Institute of Utah

Introduction: In the past, our group has popularized models for gastric bypass, sleeve and gastric imbrication.  There are currently no models to predict weight loss following Single Anastomosis Duodenal Switch.  Surgeons who offer this procedure are left to guess based on their limited experience how their patients will do following surgery.  We have developed a simple office based algorithm to predict weight loss following this procedure. 

Method: 161 patients met the criteria for this study. These patients underwent surgery at a single institution from June 2013 to December 2016. Non-linear Regression analysis was performed to interpolate weight loss at one year. A multilinear regression was run to determine the significant variables. A model was then constructed to predict weight loss after Single Anastomosis Duodenal Switch.

Results: BMI, HTN, Gender, and the interaction between HTN and DM were found to affect weight loss. The model achieved a R value of .616 and the average error of prediction in the model was 12.5%EWL.

Effect of variables on weight loss at 1-year
Variable Effect on EWL at 1-year
BMI -1.53% per point BMI
HTN -6.06%
Gender -4.97% for females
HTN and DM -5.06%

Conclusion: Today too many surgical practices offer procedures tailored to surgeon instead of the needs of the patient.  Using our models predicting postoperative weight loss can be a straightforward process using easily gathered data.  All surgeons should be doing this currently in their own practice to allow patient to choose targeted healthcare interventions based on patient’s personal goals.  


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 84987

Program Number: P570

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

42

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