Amani Jambhekar, MD, Amy Maselli, MD, Shawn Robinson, MD, Krystyna Kabata, PA, Piotr Gorecki, MD. New York Methodist Hospital
Background: Prior studies have established that race and socioeconomic factors may influence weight loss after bariatric surgery. Few studies have focused on laparoscopic sleeve gastrectomy (LSG). The objective of this study is to determine if demographic factors may predict postoperative weight loss following LSG.
Methods: Prospectively collected data on 666 consecutive LSG operations performed between February 2010 and May 2016 by a single surgeon (PG) were analyzed. Multiple regression analysis was done to determine if gender, race, or socioeconomic factors such as insurance and employment status correlated with postoperative weight loss. The presence of chronic comorbidities effecting quality of life such as Type II Diabetes (DM II) and Obstructive Sleep Apnea (OSA) were also recorded and analyzed.
Results: All studied groups had comparable preoperative BMIs (Mean 46 kg/m2). Race was not significantly associated with weight loss at any postoperative interval. Male gender was associated with increased weight loss through the first three months (48.2 +/- 12.5 lbs vs. 40.5 +/- 11 lbs; p = 0.0001). Patients with diabetes had significantly less weight loss at the six through 18 month intervals (50.4 +/- 17.9 lbs vs. 59.6 +/- 15.6 lbs at six months; p = 0.00032; 53.3 +/- 25.4 lbs vs. 80.5 +/- 31.3 lbs at 18 months; p = 0.008).Patients with obstructive sleep apnea had significantly less weight loss at the two year interval (57.5 +/- 29.2 lbs vs. 69.6 +/- 23.5 lbs; p = 0.047). Those with Medicare compared to Medicaid or commercial insurance had decreased weight loss through the first year (52.8 +/- 20.8 lbs vs. 71.4 +/- 26.4 lbs vs. 68.6 +/- 24.7 lbs; p = 0.0496). Notably, a higher percentage of patients in the Medicare insurance group were also diabetic and had OSA (65% vs. 34% vs. 36%; p = 0.002; 55% vs. 57% vs. 80%; p = 0.01). Finally, those patients who were students had the greatest weight loss at two years postoperatively with the least weight loss seen in retired patients followed by those on disability (108.0 +/-100.0 lbs vs. 26.0 +/-26.0 lbs vs. 40.0 +/-46.0 lbs; p = 0.04).
Conclusions: Several demographic factors including comorbidities, insurance status, and employment may significantly affect weight loss patterns following LSG. Further studies are needed to evaluate whether demographic differences impact long term weight loss. Differences in outcomes based on patient demographics may be beneficial in the planning of the allocation of healthcare resources.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79196
Program Number: P522
Presentation Session: Poster (Non CME)
Presentation Type: Poster