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Predictors of initial weight loss after gastric bypass surgery in twelve veterans affairs medical centers - 22/09/13

Doi : 10.1016/j.orcp.2012.02.009 
David Arterburn a, b , Edward H. Livingston c, d, e, Maren K. Olsen f, g, Valerie A. Smith f, Andrew L. Kavee f, Leila C. Kahwati h, William G. Henderson i, j, k, Matthew L. Maciejewski f, l,
a Group Health Research Institute, Seattle, WA, United States 
b Department of Medicine, Division of General Internal Medicine, University of Washington, United States 
c Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States 
d Veterans Administration North Texas Health Care System, Dallas, TX, United States 
e Department of Biomedical Engineering, University of Texas, Arlington, TX, United States 
f Center for Health Services Research in Primary Care, Durham VA Medical Center, United States 
g Department of Biostatistics and Bioinformatics, Duke University, United States 
h National Center for Health Promotion and Disease Prevention, Office of Patient Care Services, Veterans Health Administration, Department of Veterans Affairs, United States 
i Denver Veterans Affairs Medical Center, Denver, CO, United States 
j Department of Biostatistics and Informatics, School of Public Health, University of Colorado, Aurora, CO, United States 
k Colorado Health Outcomes Program, Health Sciences Center, University of Colorado, Aurora, CO, United States 
l Division of General Internal Medicine, Department of Medicine, Duke University, United States 

Corresponding author at: Center for Health Services Research in Primary Care (152), Durham VA Medical Center, 411 West Chapel Hill Street, Suite 600, Durham, NC 27705, United States. Tel.: +1 919 286 0411x5198.

Summary

The objective of this study was to identify determinants of significant weight loss one year after gastric bypass surgery among United States veterans. Using data from the Veterans Affairs (VA) Surgical Quality Improvement Program, we identified 516 veterans who had gastric bypass surgery (24% laparoscopic) in one of twelve VA bariatric centers in 2000–2006 and one or more postoperative weight measures. The probability of losing 30% or more of baseline weight at one year was estimated via logistic regression, examining the following potential predictor variables: age, gender, race, marital status, body mass index (BMI), American Society of Anesthesiologists class, comorbidity burden, smoking status, diabetes medications taken and surgical procedure (open or laparoscopic). The 516 cases had a mean BMI of 49kg/m2, mean age of 51.5 years, 74% were male, 77% were Caucasian, and 55% were married. The predicted mean weight loss was 76 (95% CI: 73–79) pounds (22%) at six months and 109 (95% CI: 104–114) pounds (32%) at one-year. Based upon estimated individual trajectories of 370 patients with adequate follow-up data, 58% of the sample lost 30% or more of their baseline weight at one year; and <1% lost <10% of their baseline weight at 1 year. In the logistic regression, patients were more likely to lose 30% or more of their baseline weight if they were female (odds ratio (OR)=2.5, p<0.01) or Caucasian (OR=2.3, p<0.01). We conclude that gastric bypass surgery yields significant weight loss for most patients in Veterans Affairs Medical Centers, but is particularly effective for female and Caucasian patients.

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Keywords : Gastric bypass surgery, Veterans, Outcomes


Plan


 This work was supported by the Office of Research and Development, Health Services Research and Development Service, Department of Veterans Affairs, project number IIR 05-201. The views expressed are those of the authors and do not reflect the views of the Department of Veterans Affairs.
☆☆ This work was supported by the Office of Research and Development, Health Services Research and Development Service, Department of Veterans Affairs (IIR 05-201, SHP 08-137).


© 2012  Asian Oceanian Association for the Study of Obesity. Tous droits réservés.
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Vol 7 - N° 5

P. e367-e376 - septembre 2013 Retour au numéro
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