Peter Gerber1, Claes Anderin2, Ulf O Gustafsson3, Anders Thorell2. 1. Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital, Stockholm, Sweden; Department of Surgery, Ersta Hospital, Stockholm, Sweden. Electronic address: peter.gerber@erstadiakoni.se. 2. Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital, Stockholm, Sweden; Department of Surgery, Ersta Hospital, Stockholm, Sweden. 3. Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital, Stockholm, Sweden; Department of Surgery, Danderyds Hospital, Stockholm, Sweden.
Abstract
BACKGROUND: Weight loss before bariatric surgery has been found to be associated with reduced rates of postoperative complications. OBJECTIVE: To evaluate whether preoperative weight loss was also associated with improved postoperative weight loss over time and if this was dependent on preoperative body mass index (BMI). SETTING: Data from the Swedish national registry for bariatric surgery. METHODS: Out of 20,564 patients undergoing primary gastric bypass from January 1, 2008 to November 30, 2011, 9570 with complete data on preoperative weight loss and 2 years postoperative weight loss were analyzed. RESULTS: Total preoperative weight loss in the 25th, 50th, and 75th percentiles was 0%, 4.5%, and 8.6%, respectively. When comparing patients in the 50th percentile for preoperative weight loss with those in the 25th percentile, total postoperative weight loss was 5.0% and 5.3% higher at 1 and 2 years, respectively (P<.001). Corresponding values for patients in the 75th percentile for preoperative weight loss were 11.8% and 10.1% (P< .001). For patients in the 75th percentile of preoperative BMI (>45.7 kg/m(2)) the effect was even more pronounced. Thus, in this group of patients and within the 75th percentile for preoperative weight loss, the total weight reduction after 1 and 2 years was 15.2% and 13.6% higher compared with patients in the 25th percentile for preoperative weight loss. CONCLUSION: In this Swedish national bariatric registry data set, weight loss before gastric bypass was associated with sustained improved postoperative weight reduction. Moreover, there was a relationship between the degree of pre- and postoperative weight loss and the relationship was stronger in patients with high BMI.
BACKGROUND:Weight loss before bariatric surgery has been found to be associated with reduced rates of postoperative complications. OBJECTIVE: To evaluate whether preoperative weight loss was also associated with improved postoperative weight loss over time and if this was dependent on preoperative body mass index (BMI). SETTING: Data from the Swedish national registry for bariatric surgery. METHODS: Out of 20,564 patients undergoing primary gastric bypass from January 1, 2008 to November 30, 2011, 9570 with complete data on preoperative weight loss and 2 years postoperative weight loss were analyzed. RESULTS: Total preoperative weight loss in the 25th, 50th, and 75th percentiles was 0%, 4.5%, and 8.6%, respectively. When comparing patients in the 50th percentile for preoperative weight loss with those in the 25th percentile, total postoperative weight loss was 5.0% and 5.3% higher at 1 and 2 years, respectively (P<.001). Corresponding values for patients in the 75th percentile for preoperative weight loss were 11.8% and 10.1% (P< .001). For patients in the 75th percentile of preoperative BMI (>45.7 kg/m(2)) the effect was even more pronounced. Thus, in this group of patients and within the 75th percentile for preoperative weight loss, the total weight reduction after 1 and 2 years was 15.2% and 13.6% higher compared with patients in the 25th percentile for preoperative weight loss. CONCLUSION: In this Swedish national bariatric registry data set, weight loss before gastric bypass was associated with sustained improved postoperative weight reduction. Moreover, there was a relationship between the degree of pre- and postoperative weight loss and the relationship was stronger in patients with high BMI.
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