Amy L Rosenbluth, MD1, Napoleon E Cieza, MD1, Koji Park, MD1, Ninan Koshy, MBBS1, E J Harvey, MD1, James McGinty, MD2, Subhash Kini, MD1. 1Mount Sinai St. Luke’s/West, 2Englewood Hospital and Medical Center
INTRODUCTION: Current guidelines recommend a multidisciplinary bariatric follow-up program for a minimum of 2 years. This has, however, been a continuous challenge. Follow-up data is widely varied, but rates average about 50% at one year and 30% at two years. Despite having an above average follow-up; we instituted an extensive system of phone calls and letters reminding patients of their scheduled and annual visits. The objective of this quality analysis study is to determine if our interventions have improved follow-up.
METHODS AND PROCEDURES: We analyzed data from patients who underwent sleeve gastrectomy (SG) or gastric bypass (RYGB). We included patients from 2-years prior to our intervention and compared this with patients who had follow-up after implementation. We excluded patients having revisions, gastric banding, and patients whose primary surgeon had left during the data collection period. We analyzed demographics and follow-up rates at 1, 3, 6, 12, and 24 months. Chi-square test was used to evaluate for significance, and results were corrected for multiple comparison.
RESULTS: 435 patients met inclusion criteria in the pre-intervention group, and 836 in the post-intervention group. Of those, 418 were analyzed for the 2 year follow-up visit. The pre-intervention group had 62 males, 373 females, and an average age of 37. Approximately 1/3 of the surgeries performed were SG, 2/3 were RYGB. The post-intervention group had 127 males, 709 females, average age of 38. Approximately half of the post-intervention cases were SG while the rest were RYGB.
Visit | Pre-Intervention | Post-Intervention | P-Value |
---|---|---|---|
1 Month | 98.9% | 98.9% | 0.91 |
3 Month | 80.9% | 90.4% | <0.00001 |
6 Month | 66.2% | 91.4% | <0.00001 |
12 Month | 58.4% | 63.0% | 0.11 |
24 Month | 57.2% | 51.4% | 0.09 |
CONCLUSION: Bariatric surgery is a useful tool in aiding weight loss and improving comorbidities. It is essential that patients receive long-term follow-up and monitoring to achieve these goals. Our program now uses a system of phone call reminders for scheduled visits, as well as calls and letters for annual visits. It has been very effective in improving short term follow-up. Further work is needed, however, to improve long-term follow-up. Consideration could be given to other innovative methods to improve follow-up.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86956
Program Number: P761
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster