Predictors of Postoperative Aftercare Attrition among Gastric Bypass Patients
Open accessAbstract
Background: Poor adherence to post-bariatric surgery aftercare continues to challenge surgical practices. The objective of this study was to identify factors that predict poor aftercare attendance among patients who underwent Roux-en-Y Gastric Bypass (RYGB) surgery. Method: A retrospective medical chart review of patients who underwent RYGB from 2002 to 2011 was conducted. Patients with four visits or more in the first 2 years (>50%) were categorized as “acceptable follow-up” and with ≤50% as “poor follow-up.” Demographics, presurgical body mass index (BMI), and comorbidities were compared using multivariate analysis. Results: Out of 2,658 patients, 1,092 (41.1%) had acceptable follow-up. Preoperative factors that predicted acceptable follow-up included female gender (odds ratio [OR] 1.41 [95% confidence interval (CI) 1.15–1.72]), older age (OR 1.03 [95% CI 1.03–1.04]), higher BMI at surgery (OR 1.02 [95% CI 1.01–1.03]), and Hispanic ethnicity (OR 1.40 [95% CI 1.15–1.72]). Conversely, presence of diabetes mellitus (OR 0.58 [95% CI 0.39–0.88]), hypertension (OR 0.53 [95% CI 0.39–0.72]), and obstructive sleep apnea (OR 0.39 [95% CI 0.26–0.57]) predicted less adherence to RYGB aftercare. Conclusion: These findings suggest RYGB patients' age, gender, ethnicity, preoperative BMI, and certain comorbidities should be considered to maximize postoperative aftercare attendance.
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Pre-operative diagnosis of depression was predictive of missing follow-up appointments in the 24 months after gastric bypass surgery in three separate studies.
“Pre‐operative diagnosis of depression, high levels of depressive symptomology, and a history of pharmacological treatment of depression were predictive of missing follow‐up appointments in the 24 months after gastric bypass surgery in three separate studies. 13 , 18 , 19”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [19]
In the Results (page not available), preoperative depression was more common among patients with poor follow-up over the first two years (10.4%) than among those with acceptable follow-up (5.8%). However, depression was not an independent predictor in the paper’s multivariate analysis, so describing it as predictive overstates this study’s finding. The three-study wording refers to the sentence’s multiple citations, not to three studies in this source. (LLM, conf=0.88)
Experimental — accuracy not yet measuredHigh levels of pre-operative depressive symptomology were predictive of missing follow-up appointments in the 24 months after gastric bypass surgery in three separate studies.
“Pre‐operative diagnosis of depression, high levels of depressive symptomology, and a history of pharmacological treatment of depression were predictive of missing follow‐up appointments in the 24 months after gastric bypass surgery in three separate studies. 13 , 18 , 19”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [19]
The Discussion (page unavailable) reports that higher Beck Depression Inventory scores were associated with aftercare attrition in other studies. It does not establish that this association concerned missed appointments specifically within 24 months; in this paper’s own Results (page unavailable), depression was more frequent among patients with poor follow-up but was not identified as an independent predictor. (LLM, conf=0.82)
Experimental — accuracy not yet measuredA history of pharmacological treatment of depression was predictive of missing follow-up appointments in the 24 months after gastric bypass surgery in three separate studies.
“Pre‐operative diagnosis of depression, high levels of depressive symptomology, and a history of pharmacological treatment of depression were predictive of missing follow‐up appointments in the 24 months after gastric bypass surgery in three separate studies. 13 , 18 , 19”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [19]
In the Results (Table 1), depression was more common among patients with poor follow-up during the first two years after gastric bypass. The paper does not identify a history of pharmacological depression treatment as a predictor, and depression is absent from its multivariate predictor table (Table 2). This source is one study, not evidence for the claim about three studies. (LLM, conf=0.88)
Experimental — accuracy not yet measured
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“13,18,19 23 In studies examining anxiety, higher levels of pre ‐ operative phobic anxiety 20 and an avoidant attachment style were associated with a lower likelihood of appointment attendance in the first 6–12 months post ‐ surgery.”
Background
- Authors
- Khorgami, Z., Zhang, C., Messiah, S. E., & de la Cruz-Muñoz, N.
- Affiliations
- University of Miami (US)
- Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida.
- Venue
- Bariatric Surgical Practice and Patient Care
- Publisher
- SAGE Publications
- Published
- 2015-06
- Volume
- 10
- Issue
- 2
- Pages
- 79-83
- ISSN
- 2168-023X (ISSN-L)
- 2168-0248
- PMC
- PMC4491160
- OpenAlex
- W1862338193
- Cited by
- 54
- References
- 28
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 5 · 2023: 4 · 2022: 6 · 2021: 13 · 2020: 2 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 2 · 2015: 2
- FWCI
- 4.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Bariatric Surgical Practice and Patient Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- Roux-en-Y gastric bypass, postoperative follow-up, bariatric surgery, body mass index, diabetes mellitus, hypertension, obstructive sleep apnea, Hispanic origin, sex differences, comorbidities
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