Predictive factors of weight regain following laparoscopic Roux-en-Y gastric bypass.

Autor: Keith CJ Jr; Department of Surgery, University of Alabama at Birmingham, 1720 2nd Ave South, KB 401, Birmingham, AL, 35294, USA., Gullick AA; Department of Surgery, University of Alabama at Birmingham, 1720 2nd Ave South, KB 401, Birmingham, AL, 35294, USA., Feng K; Department of Surgery, University of Alabama at Birmingham, 1720 2nd Ave South, KB 401, Birmingham, AL, 35294, USA., Richman J; Department of Surgery, University of Alabama at Birmingham, 1720 2nd Ave South, KB 401, Birmingham, AL, 35294, USA.; Center for Surgical, Medical Acute Care Research, and Transitions, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA., Stahl R; Department of Surgery, University of Alabama at Birmingham, 1720 2nd Ave South, KB 401, Birmingham, AL, 35294, USA., Grams J; Department of Surgery, University of Alabama at Birmingham, 1720 2nd Ave South, KB 401, Birmingham, AL, 35294, USA. jgrams@uab.edu.; Department of Surgery, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA. jgrams@uab.edu.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2018 May; Vol. 32 (5), pp. 2232-2238. Date of Electronic Publication: 2017 Oct 24.
DOI: 10.1007/s00464-017-5913-2
Abstrakt: Background: Strategies to address weight recidivism following Roux-en-Y gastric bypass (RYGB) could be developed if patients at risk were identified in advance. This study aimed to determine factors that predict weight regain.
Methods: Retrospective review was performed of patients who underwent laparoscopic RYGB at a single institution over 10 years. Group-based modeling was used to estimate trajectories of weight regain after nadir and stratify patients based on percent weight change (%WC).
Results: Three trajectories were identified from 586 patients: 121 had ongoing weight loss, 343 were weight stable, and 122 regained weight. Male sex (p = 0.020) and white race (p < 0.001) were associated with stable weight or weight regain. Being from a neighborhood of socioeconomic advantage (p = 0.035) was associated with weight regain. Patients with weight regain experienced improved percent weight loss (%WL) at nadir (p < 0.001) and ΔBMI (p = 0.002), yet they had higher weight and BMI and lower %WL and ΔBMI than the other two groups during long-term follow-up. On multivariate analyses, those who regained weight were more likely from socioeconomically advantaged neighborhoods (OR 1.82, CI 1.18-2.79).
Conclusions: Several patient-related characteristics predicted an increased likelihood of weight regain. Further studies are needed to elucidate how these factors contribute to weight recidivism following bariatric surgery.
Databáze: MEDLINE
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