Rui Mao1, Pengsen Guo1, Ziwei Lin2, Huawu Yang3, Muthukumaran Jayachandran2, Chenxin Xu1, Tongtong Zhang4,5, Shen Qu6, Yanjun Liu7,8. 1. Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610036, China. 2. Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, No. 301 Middle Yanchang Road, Shanghai, 200072, China. 3. The Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu; Affiliated Hospital of Southwest Jiaotong University, Qinglong Road, Chengdu, 610031, China. 4. Medical Research Center, The Third People's Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Sichuan Province, Chengdu, 610031, China. 163zttong@163.com. 5. Medical Research Center, The Third People's Hospital of Chengdu, 82 Qinglong street, Qingyang District, Chengdu, 610031, Sichuan Province, China. 163zttong@163.com. 6. Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, No. 301 Middle Yanchang Road, Shanghai, 200072, China. qushencn@hotmail.com. 7. Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610036, China. liuyanjun_001@163.com. 8. The Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu; Affiliated Hospital of Southwest Jiaotong University, Qinglong Road, Chengdu, 610031, China. liuyanjun_001@163.com.
Abstract
BACKGROUND: As a reflection of the increasing global incidence of obesity, there is a corresponding increase in the proportion of obese patients undergoing bariatric surgery. This study reviewed the factors and outcomes of patients who underwent bariatric surgical procedures and determined the relationships and developed a nomogram to calculate individualized patient risk. METHODS: The nomogram was based on a retrospective study on 259 patients who underwent bariatric surgery at the Chengdu Third People's Hospital from June 2017 to June 2019. The predictive accuracy and discriminative ability of the nomogram were determined by the ROC curve and C-index, respectively. The results were validated using bootstrap resampling and a retrospective study on 121 patients operated on from May 2015 to May 2019 at the Tenth People's Hospital of Shanghai. RESULTS: The predictors contained in the prediction nomogram included age, sex, surgical approach, hyperlipidemia, blood pressure (BP), hyperuricemia, body mass index (BMI), and waist circumference (WC). The 6-month model displayed good discrimination with a C-index of 0.765 (95% CI: 0.756 to 0.774) and good calibration. The 1-year model reached a C-index of 0.768 (95% CI, 0.759 to 0.777) in the training cohort. CONCLUSIONS: The proposed nomogram resulted in more accurate non-remission prediction for patients with obesity after bariatric surgery and may provide a reference for the preoperative choice of surgical methods.
BACKGROUND: As a reflection of the increasing global incidence of obesity, there is a corresponding increase in the proportion of obesepatients undergoing bariatric surgery. This study reviewed the factors and outcomes of patients who underwent bariatric surgical procedures and determined the relationships and developed a nomogram to calculate individualized patient risk. METHODS: The nomogram was based on a retrospective study on 259 patients who underwent bariatric surgery at the Chengdu Third People's Hospital from June 2017 to June 2019. The predictive accuracy and discriminative ability of the nomogram were determined by the ROC curve and C-index, respectively. The results were validated using bootstrap resampling and a retrospective study on 121 patients operated on from May 2015 to May 2019 at the Tenth People's Hospital of Shanghai. RESULTS: The predictors contained in the prediction nomogram included age, sex, surgical approach, hyperlipidemia, blood pressure (BP), hyperuricemia, body mass index (BMI), and waist circumference (WC). The 6-month model displayed good discrimination with a C-index of 0.765 (95% CI: 0.756 to 0.774) and good calibration. The 1-year model reached a C-index of 0.768 (95% CI, 0.759 to 0.777) in the training cohort. CONCLUSIONS: The proposed nomogram resulted in more accurate non-remission prediction for patients with obesity after bariatric surgery and may provide a reference for the preoperative choice of surgical methods.
Authors: Philip R Schauer; Deepak L Bhatt; John P Kirwan; Kathy Wolski; Ali Aminian; Stacy A Brethauer; Sankar D Navaneethan; Rishi P Singh; Claire E Pothier; Steven E Nissen; Sangeeta R Kashyap Journal: N Engl J Med Date: 2017-02-16 Impact factor: 91.245
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