Multimodal approach utilising a weight management programme prior to bariatric surgery in patients with BMI ≥50 kg/m2: A propensity score matching retrospective cohort study

IF 2.2 Q3 ENDOCRINOLOGY & METABOLISM

Clinical Obesity Pub Date : 2024-04-25 DOI:10.1111/cob.12669

Cetin Sari, Connie Santana, Richard L. Seip, Dale Bond, Aziz Benbrahim, Edward Hannoush, Tara McLaughlin, Ya-Huei Li, Ilene Staff, Yin Wu, Pavlos Papasavas, Darren Tishler, Devika Umashanker

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Abstract

We evaluated preoperative weight loss and days from initial consult to surgery in patients with BMI ≥50 kg/m² who were and were not enrolled in medical weight management (MWM) prior to laparoscopic sleeve gastrectomy. We retrospectively identified patients with BMI ≥50 kg/m² who had primary sleeve gastrectomy between 2014 and 2019 at two bariatric surgery centres in our healthcare system. Patients presenting after 2017 that received preoperative MWM (n = 28) were compared to a historical cohort of non-MWM patients (n = 118) presenting prior to programme initiation in 2017 on preoperative percent total body weight loss (%TBWL) and days from initial consult to surgery. A total of 151 patients (MWM, 33; non-MWM, 118) met inclusion criteria. BMI was significantly greater in MWM versus non-MWM (p = .018). After propensity score matching, median BMI at initial consult in non-MWM versus MWM no longer differed (p = .922) neither were differences observed on the basis of weight, age, sex, race or ethnicity. After PSM, MWM had significantly lower BMI at surgery (p = .018), lost significantly more weight from consult to surgery (p < .001) and achieved significantly greater median %TBWL from consult to surgery (p < .001). We noted no difference between groups on 6-month weight loss (p = .533). Days from initial consult to surgery did not differ between groups (p < .863). A preoperative MWM programme integrated into multimodal treatment for obesity in patients with a BMI ≥50 kg/m² resulted in clinically significant weight loss without prolonging time to surgery.

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对体重指数≥50 kg/m2的患者进行减肥手术前利用体重管理计划的多模式方法：倾向得分匹配回顾性队列研究。

我们评估了体重指数（BMI）≥50 kg/m2、在腹腔镜袖状胃切除术前接受或未接受医学体重管理（MWM）的患者的术前体重减轻情况以及从初诊到手术的天数。我们回顾性地确定了2014年至2019年期间在我们医疗系统的两个减肥手术中心接受初级袖带胃切除术的BMI≥50 kg/m2患者。将2017年后就诊并接受术前MWM的患者（n = 28）与2017年计划启动前就诊的非MWM患者历史队列（n = 118）就术前总体重减轻百分比（%TBWL）和从初次就诊到手术的天数进行比较。共有151名患者（MWM，33人；非MWM，118人）符合纳入标准。MWM患者的体重指数明显高于非MWM患者（P = .018）。经过倾向得分匹配后，非 MWM 与 MWM 初次就诊时的 BMI 中位数不再存在差异（p = .922），也没有观察到体重、年龄、性别、种族或民族方面的差异。在 PSM 之后，MWM 在手术时的体重指数明显降低（p = .018），从就诊到手术的体重减轻幅度明显更大（p < .001），从就诊到手术的中位体重减轻百分比明显更高（p < .001）。我们注意到两组患者在 6 个月体重减轻方面没有差异（p = .533）。两组患者从初次就诊到手术的天数没有差异（p < .863）。对于体重指数（BMI）≥50 kg/m2的肥胖症患者，将术前MWM计划整合到肥胖症多模式治疗中，可在不延长手术时间的情况下实现显著的临床减重效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Obesity ENDOCRINOLOGY & METABOLISM-

CiteScore

5.90

自引率

3.00%

发文量

期刊介绍： Clinical Obesity is an international peer-reviewed journal publishing high quality translational and clinical research papers and reviews focussing on obesity and its co-morbidities. Key areas of interest are: • Patient assessment, classification, diagnosis and prognosis • Drug treatments, clinical trials and supporting research • Bariatric surgery and follow-up issues • Surgical approaches to remove body fat • Pharmacological, dietary and behavioural approaches for weight loss • Clinical physiology • Clinically relevant epidemiology • Psychological aspects of obesity • Co-morbidities • Nursing and care of patients with obesity.