Polly A Hulme1, Kevin A Kupzyk2, Gary J Anthone3, Kimberly A Capron4, Thang Nguyen5. 1. College of Nursing, South Dakota State University, Wagner Hall 204, Brookings, SD, 57007, USA. polly.hulme@sdstate.edu. 2. College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA. 3. Department of Surgery, Creighton University, 10506 Burt Circle, Omaha, NE, 68144, USA. 4. Bristol-Myers Squibb, 507 29th Circle, Fremont, NE, 68025, USA. 5. Nebraska Medicine, 987400 Nebraska Medical Center, Omaha, NE, 68198-7400, USA.
Abstract
BACKGROUND: Bariatric surgery patients who report physical or sexual abuse form a sizeable cohort that stands out due to psychological comorbidity. Their possible vulnerability to suboptimal weight loss remains of interest. Their risk for malnutrition due to inadequate oral intake following surgery is underexplored. OBJECTIVES: Study aims were to determine the effect of self-reported physical or sexual abuse in patients undergoing open biliopancreatic diversion with duodenal switch (BPD/DS) on (a) 3-year weight loss trajectories and (b) timing of feeding jejunostomy tube (J tube) removal. Delayed J tube removal served as an indicator for inadequate oral intake. METHODS: In this retrospective cohort study, the sample (N = 189) consisted of all patients who underwent primary BPD/DS by the same surgeon during 2009 and 2010 at a Midwestern health system. All patients had a J tube placed during surgery. Longitudinal mixed models were used for testing differences in weight loss trajectories by abuse status. RESULTS: There were no significant differences in weight loss trajectories by abuse status. The abused group had the J tube in place a mean of 61.9 days (SD = 39.5) compared to 44.8 days (SD = 32.8) for the not abused group, a significant difference. CONCLUSIONS: Our use of the best available statistical methods lends validity to previous findings that suggest physical or sexual abuse does not affect weight loss after bariatric surgery. Increased likelihood of persistent inadequate oral intake in the abused group suggests the need for early multidisciplinary interventions that include mental health and nutrition experts.
BACKGROUND: Bariatric surgery patients who report physical or sexual abuse form a sizeable cohort that stands out due to psychological comorbidity. Their possible vulnerability to suboptimal weight loss remains of interest. Their risk for malnutrition due to inadequate oral intake following surgery is underexplored. OBJECTIVES: Study aims were to determine the effect of self-reported physical or sexual abuse in patients undergoing open biliopancreatic diversion with duodenal switch (BPD/DS) on (a) 3-year weight loss trajectories and (b) timing of feeding jejunostomy tube (J tube) removal. Delayed J tube removal served as an indicator for inadequate oral intake. METHODS: In this retrospective cohort study, the sample (N = 189) consisted of all patients who underwent primary BPD/DS by the same surgeon during 2009 and 2010 at a Midwestern health system. All patients had a J tube placed during surgery. Longitudinal mixed models were used for testing differences in weight loss trajectories by abuse status. RESULTS: There were no significant differences in weight loss trajectories by abuse status. The abused group had the J tube in place a mean of 61.9 days (SD = 39.5) compared to 44.8 days (SD = 32.8) for the not abused group, a significant difference. CONCLUSIONS: Our use of the best available statistical methods lends validity to previous findings that suggest physical or sexual abuse does not affect weight loss after bariatric surgery. Increased likelihood of persistent inadequate oral intake in the abused group suggests the need for early multidisciplinary interventions that include mental health and nutrition experts.
Entities:
Keywords:
Bariatric surgery; Biliopancreatic diversion; Jejunostomy; Malnutrition; Physical abuse; Sexual offenses; Weight loss
Authors: Nayna A Lodhia; Ulysses S Rosas; Michelle Moore; Alan Glaseroff; Dan Azagury; Homero Rivas; John M Morton Journal: J Gastrointest Surg Date: 2015-04-02 Impact factor: 3.452
Authors: Ida J Hatoum; Robin Blackstone; Tina D Hunter; Diane M Francis; Michael Steinbuch; Jason L Harris; Lee M Kaplan Journal: JAMA Surg Date: 2016-02 Impact factor: 14.766
Authors: Marc Bessler; Amna Daud; Mary F DiGiorgi; Beth A Schrope; William B Inabnet; Daniel G Davis Journal: Surg Obes Relat Dis Date: 2008-06-30 Impact factor: 4.734