Determinants of Patient’s Adherence to the Predefined Follow-up Visits After Bariatric Surgery

Abstract

Introduction Multidisciplinary care after bariatric surgery is essential for long-term safety and optimal weight loss. However, many patients do not participate in routine postoperative follow-ups. We have explored the determinants of patients’ adherence to scheduled follow-up visits after bariatric surgery. Method A retrospective cohort study was performed on patients who underwent bariatric surgery from 2009 to 2019. Cohort participants with a proportion of attendance above the median were compared with those below the median in the first-year post-operation and the period after that. We assumed that the contribution of each predefined session to the overall attendance at eligible sessions is not equal. We weighted each predefined session by the proportion of attendance of all cohort members scheduled for that session. We then calculated the proportion of attendance for each individual at each period. Discriminatory logistic regression was used to identify factors separating adherers from non-adherers. Results We followed 5245 patients who underwent bariatric surgery for up to 10 years. The median follow-up was 2 years. Patients with the following characteristics were more likely to comply with the postoperative attendance schedule: female sex, older age, higher body mass index at the first visit, non-smoker, readmission after surgery, being operated in a general hospital, and one-anastomosis gastric bypass (OAGB) or Roux-en-Y gastric bypass (RYGB) surgery type. Comorbidities did not significantly affect patients’ adherence to the predefined follow-up schedules. Conclusion Younger male smokers are more likely non-adherers. Patients with comorbidities are not at an increased risk of missing predefined postoperative follow-up visits. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s11695-022-06428-8.

Marginal Ulcer Perforation after One Anastomosis Gastric Bypass: Surgical Treatment and Two-Year Outcomes

“…Their study was based primarily on RYGB, and there are multiple additional and cultural factors that may play a role in the pathophysiology and development of MU perforation. The finding of a male predominance could be related to the fact that male patients have a greater tendency to smoke [ 18 ], which is a well-documented risk factor for MU [ 19 ], and men are also reported to be less adherent to post-operative clinical follow up [ 20 ]. Our findings support cigarette smoking as a risk factor for the development of MU and its perforation, as nine of our patients were active smokers (41%).…”