Long-term success and failure with SG is predictable by 3 months: a multivariate model using simple office markers

Surg Obes Relat Dis. 2017 Aug;13(8):1266-1270. doi: 10.1016/j.soard.2017.03.016. Epub 2017 Mar 23.

Abstract

Introduction: Despite being the most common surgery in the United States, little is known about predicting weight loss success and failure with sleeve gastrectomy (SG). Papers that have been published are inconclusive. We decided to use multivariate analysis from 2 practices to design a model to predict weight loss outcomes using data widely available to any surgical practice at 3 months to determine weight loss outcomes at 1 year.

Setting: Two private practices in the United States.

Methods: A retrospective review of 613 patients from 2 bariatric institutions were included in this study. Co-morbidities and other preoperative characteristics were gathered, and %EWL was calculated for 1, 3, and 12 months. Excess weight loss (%EWL)<55% at 1 year was defined as weight loss failure. Multiple variate analysis was used to find factors that affect %EWL at 12 months.

Results: Preoperative sleep apnea, preoperative diabetes, %EWL at 1 month, and %EWL at 3 months all affect %EWL at 1 year. The positive predictive value and negative predictive value of our model was 72% and 91%, respectively. Sensitivity and specificity were 71% and 91%, respectively.

Conclusion: One-year results of the SG can be predicted by diabetes, sleep apnea, and weight loss velocity at 3 months postoperatively. This can help surgeons direct surgical or medical interventions for patients at 3 months rather than at 1 year or beyond.

Keywords: Obesity; Obesity surgery; Sleeve gastrectomy; Sleeve gastrectomy failure; Sleeve gastrectomy model; Weight loss model.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Bariatric Surgery / methods*
  • Diabetes Mellitus, Type 2 / complications
  • Female
  • Gastrectomy / methods*
  • Gastroesophageal Reflux / complications
  • Humans
  • Hypertension / complications
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity, Morbid / complications
  • Obesity, Morbid / surgery*
  • Predictive Value of Tests
  • ROC Curve
  • Retrospective Studies
  • Sleep Apnea Syndromes / complications
  • Time Factors
  • Treatment Outcome
  • Weight Loss