Does age affect outcome of gastric bypass surgery?

Introduction The Roux-en-Y gastric bypass (RYGB) has been employed for more than 3 decades. However, there are no normative data to aid the bariatric surgeon in assessing the adequacy of weight loss at each postoperative visit. Objective To construct nomograms to aid in assessment of weight loss. Setting University Hospital, United States Methods We used data prospectively collected from 1216 patients who underwent RYGB at Duke University between April 2000 and September 2007. Percent excess weight loss (EWL) was determined for each follow-up visit (1, 3, 6, 12, and 36 months). EWL velocity was also determined using postoperative data collected at 1 and 3 month visits. Multivariate analysis was used to determine predictive factors that influence long term results. Results At 12 months follow up, the majority of patients, especially those in the 1st and 4th quartiles (p=0.01) continue to be in the same weight loss quartile where they were initially classified at 1 month postoperatively. The positive and negative predictive values for 1st quartile EWL at 1 month resulting in 1st quartile EWL at 12 months was 39% and 81%, respectively. The multivariate analysis indicated that sex, preoperative body mass index (BMI), EWL at 1 month, and EWL velocity were statistically significant predictors of EWL at 12 months. Conclusions We are the first group to determine that weight loss performance in the early period is a significant predictor of long term outcome. The clinical utility of the weight loss chart is to identify underperformers early postoperatively and potentially improve outcomes.

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“…Additionally, age was also not found to be a significant predictor of weight loss, in concordance with previous reports (24-28) .…”

Section: Discussionsupporting

confidence: 92%

Weight loss at first postoperative visit predicts long-term outcome of Roux-en-Y gastric bypass using Duke weight loss surgery chart

Mor¹,

Sharp²,

Portenier³

et al. 2012

Surgery for Obesity and Related Diseases

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“…Type 2 diabetes has been shown to be associated with decreased weight loss after surgery (26,27), as has a limited dieting history (28) and being married (29). Increased age is associated with blunted weight loss as well as a higher incidence of complications after surgery (30,31), but the effects of age are not so robust as to exclude older patients from consideration of surgical treatment (24,32,33). One of the most consistently reported predictors of weight loss following surgery is initial BMI; however, the nature and direction of this relationship depends on how outcome is assessed.…”

Section: Introductionmentioning

confidence: 99%

Capacity for Physical Activity Predicts Weight Loss After Roux‐en‐Y Gastric Bypass

Hatoum

Stein

Merrifield

et al. 2009

Obesity

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Despite its overall excellent outcomes, weight loss after Roux-en-Y gastric bypass (RYGB) is highly variable. We conducted this study to identify clinical predictors of weight loss after RYGB. We reviewed charts from 300 consecutive patients who underwent RYGB from August 1999 to November 2002. Data collected included patient demographics, medical comorbidities, and diet history. Of the 20 variables selected for univariate analysis, 9 with univariate P values ≤ 0.15 were entered into a multivariable regression analysis. Using backward selection, covariates with P < 0.05 were retained. Potential confounders were added back into the model and assessed for effect on all model variables. Complete records were available for 246 of the 300 patients (82%). The patient characteristics were 75% female, 93% white, mean age of 45 years, and mean initial BMI of 52.3 kg/m2. One year after surgery, patients lost an average of 64.8% of their excess weight (s.d. = 20.5%). The multivariable regression analysis revealed that limited physical activity, higher initial BMI, lower educational level, diabetes, and decreased attendance at postoperative appointments had an adverse effect on weight loss after RYGB. A model including these five factors accounts for 41% of the observed variability in weight loss (adjusted r2 = 0.41). In this cohort, higher initial BMI and limited physical activity were the strongest predictors of decreased excess weight loss following RYGB. Limited physical activity may be particularly important because it represents an opportunity for potentially meaningful pre- and postsurgical intervention to maximize weight loss following RYGB.

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Does age affect outcome of gastric bypass surgery?

Cited by 2 publications

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Weight loss at first postoperative visit predicts long-term outcome of Roux-en-Y gastric bypass using Duke weight loss surgery chart

Weight loss at first postoperative visit predicts long-term outcome of Roux-en-Y gastric bypass using Duke weight loss surgery chart

Capacity for Physical Activity Predicts Weight Loss After Roux‐en‐Y Gastric Bypass

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