[Predictors of long-term therapeutic failure after bariatric surgery: a logistic regression model based on nutritional and metabolic parameters].

IF 2.5 4区医学 Q3 BUSINESS

Nutricion hospitalaria Pub Date : 2025-06-23 DOI:10.20960/nh.05886

Ángel Martínez González, Manuella González Nunes, Francisco Javier Fraile Amador, Noelia Pena Piñeiro, Maite Argibay Ulloa, Raquel Ruades Patiño

{"title":"[Predictors of long-term therapeutic failure after bariatric surgery: a logistic regression model based on nutritional and metabolic parameters].","authors":"Ángel Martínez González, Manuella González Nunes, Francisco Javier Fraile Amador, Noelia Pena Piñeiro, Maite Argibay Ulloa, Raquel Ruades Patiño","doi":"10.20960/nh.05886","DOIUrl":null,"url":null,"abstract":"Objective: this study analyzed long-term therapeutic failure after bariatric surgery and validated a 10-year predictive risk model. We aimed to integrate clinical and postoperative variables to identify failure-associated factors and establish a clinically useful threshold for follow-up.Methods: an observational study included 200 patients (78.1 % female, mean age 41.3 years, BMI 44.6 kg/m²) undergoing gastric bypass (n = 120) or sleeve gastrectomy (n = 80). Therapeutic failure was defined as < 50 % excess weight loss or comorbidity recurrence. A logistic regression model incorporated baseline BMI, 1-year %EWL, BMI loss, T2DM, and HTN. Validation used ROC curves and Hosmer-Lemeshow testing.Results: failure rates increased from 18 % to 32 % over 10 years.Risk factors: higher baseline BMI (OR = 1.24), T2DM (OR = 3.77), and HTN (OR = 3.83). One-year BMI loss was protective (OR = 0.72). The model showed strong predictive capacity (AU C = 0.858), with an optimal threshold of 28.6 % (sensitivity 84.6 %, specificity 80.6 %, NPV 93.1 %). Gastric bypass had lower failure rates (28 % vs. 38 %) and better predictive performance (AUC = 0.89 vs. 0.78).Conclusions: the model effectively predicts long-term failure, with gastric bypass demonstrating superior outcomes. We recommend prioritizing this procedure for patients with higher BMI or comorbidities.","PeriodicalId":19385,"journal":{"name":"Nutricion hospitalaria","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutricion hospitalaria","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.20960/nh.05886","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"BUSINESS","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: this study analyzed long-term therapeutic failure after bariatric surgery and validated a 10-year predictive risk model. We aimed to integrate clinical and postoperative variables to identify failure-associated factors and establish a clinically useful threshold for follow-up.

Methods: an observational study included 200 patients (78.1 % female, mean age 41.3 years, BMI 44.6 kg/m²) undergoing gastric bypass (n = 120) or sleeve gastrectomy (n = 80). Therapeutic failure was defined as < 50 % excess weight loss or comorbidity recurrence. A logistic regression model incorporated baseline BMI, 1-year %EWL, BMI loss, T2DM, and HTN. Validation used ROC curves and Hosmer-Lemeshow testing.

Results: failure rates increased from 18 % to 32 % over 10 years.

Risk factors: higher baseline BMI (OR = 1.24), T2DM (OR = 3.77), and HTN (OR = 3.83). One-year BMI loss was protective (OR = 0.72). The model showed strong predictive capacity (AU C = 0.858), with an optimal threshold of 28.6 % (sensitivity 84.6 %, specificity 80.6 %, NPV 93.1 %). Gastric bypass had lower failure rates (28 % vs. 38 %) and better predictive performance (AUC = 0.89 vs. 0.78).

Conclusions: the model effectively predicts long-term failure, with gastric bypass demonstrating superior outcomes. We recommend prioritizing this procedure for patients with higher BMI or comorbidities.

查看原文本刊更多论文

[减肥手术后长期治疗失败的预测因素：基于营养和代谢参数的logistic回归模型]。

目的：本研究分析了减肥手术后的长期治疗失败，并验证了一个10年预测风险模型。我们的目的是整合临床和术后变量，以确定失败相关因素，并建立临床有用的随访阈值。方法：观察性研究纳入200例患者（78.1%为女性，平均年龄41.3岁，体重指数44.6 kg/m²），接受胃分流术（n = 120）或袖式胃切除术（n = 80）。治疗失败的定义是体重减轻< 50%或合并症复发。logistic回归模型包括基线BMI、1年EWL %、BMI损失、T2DM和HTN。采用ROC曲线和Hosmer-Lemeshow检验进行验证。结果：10年间，失败率从18%上升到32%。危险因素：较高的基线BMI （OR = 1.24）、T2DM （OR = 3.77）和HTN （OR = 3.83）。一年的BMI下降具有保护作用（OR = 0.72）。该模型具有较强的预测能力（AU C = 0.858），最佳阈值为28.6%（敏感性84.6%，特异性80.6%,NPV 93.1%）。胃旁路术的失败率较低（28%对38%），预测性能较好（AUC = 0.89对0.78）。结论：该模型能有效预测长期衰竭，胃旁路治疗效果更好。我们建议对BMI较高或有合并症的患者优先进行此手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Nutricion hospitalaria 医学-营养学

CiteScore

1.90

自引率

8.30%

发文量

181

审稿时长

3-6 weeks

期刊介绍： The journal Nutrición Hospitalaria was born following the SENPE Bulletin (1981-1983) and the SENPE journal (1984-1985). It is the official organ of expression of the Spanish Society of Clinical Nutrition and Metabolism. Throughout its 36 years of existence has been adapting to the rhythms and demands set by the scientific community and the trends of the editorial processes, being its most recent milestone the achievement of Impact Factor (JCR) in 2009. Its content covers the fields of the sciences of nutrition, with special emphasis on nutritional support.