Kate Mellion, MD, Tyler Jones, MD, Lala Hussain, MSc, MHA, George Kerlakian, MD, Kevin Tymitz. Good Samaritan Hospital
INTRODUCTION: This study was designed to determine whether age or preoperative body mass index (BMI) influenced weight loss in bariatric patients undergoing sleeve gastrectomy (SG).
METHODS AND PROCEDURES: A retrospective chart review was conducted of adult bariatric surgery patients undergoing SG at a single institution from March 2012 to December 2015. Patients were identified using procedure code. Patients who had a previous gastric band were excluded. Demographic variables included age, race, gender, preoperative BMI, American Society of Anesthesiologists (ASA) class, and comorbidities. The outcome measure, percent of excess weight loss (%EWL), was calculated from postoperative weight at 6, 12 and 24 months. 30-day mortality and readmissions were also reported. The %EWL was compared among both age groups (<35 years, 35-50 years, >50 years) and preoperative BMI (<35, 35-40, 40-50, >50). One-way ANOVA or the Kruskal-Wallis test was used to compare continuous data across all groups. Subsequent analysis of categorical data was achieved by Chi-square or Fisher’s Exact test. Statistical significance was accepted as p<0.05.
RESULTS: A total of 160 patients (20% male) were analyzed. Average age and preoperative BMI were 45.8 (10.9) years and 44.8 (8.2) kg/m2, respectively. Preoperative comorbidities included: diabetes (20.6%), hypertension (46.3%), hyperlipidemia (29.4%), previous myocardial infarction (1.9%), obstructive sleep apnea (30.0%), chronic obstructive pulmonary disease (2.5%), gastroesophageal reflux (30.0%), tobacco use (8.8%). The ASA classes of patients undergoing SG were II (14.4%), III (84.4%), and IV (1.3%). The follow up rate at 6, 12 and 24 months was 86.9%, 44.4%, and 18.8%, respectively. The 30-day mortality and readmission rate were 0% and 4.4%, respectively. The %EWL was not different among age groups at 6, 12 or 24 months for the total, male, or female cohorts. Among preoperative BMI groups, %EWL was not different in any cohort at 12 or 24 months, but was different at 6 months for the total cohort (p<0.001) and female cohort (p<0.001), and trended toward significance in the male cohort (p=0.051). The highest %EWL was found to be in patients with preoperative BMI of 35-40. There was no difference in 30-day mortality or readmissions among groups.
CONCLUSIONS: We found a significant difference in %EWL in patients undergoing SG at 6 months postoperatively among preoperative BMI groups in the total and female cohorts. Patients with preoperative BMI of 35-40 had the highest %EWL without a difference in 30-day mortality or readmission. Optimal timing for bariatric surgery may be at a BMI of 35-40.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86498
Program Number: P657
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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