Predictors of weight loss at 1 year after laparoscopic adjustable gastric banding and the role of presurgical quality of life.
BACKGROUND
There is uncertainty regarding preoperative predictors of a successful outcome for bariatric surgery (BarSurg), on which to determine appropriateness for such a procedure. Our aims were to identify preoperative clinical and psychosocial predictors of success following BarSurg and to explore the influence of body mass index (BMI) on these parameters.


METHODS
Preoperative data, including Impact of Weight on Quality of Life-Lite (IWQOL-Lite) scores transformed to Health-Related Quality of Life (HRQOL) scores, were accrued from 76 morbidly obese adults awaiting BarSurg. Pre- and postoperative data were also accrued for 26 patients who had completed 1-year follow-up post-bariatric surgery (laparoscopic adjustable gastric banding-LAGB). Statistical analysis was performed to assess the relationships between preoperative HRQOL scores, preoperative BMI and excess weight loss 1 year following BarSurg (EWL-1 year).


RESULTS
Preoperative BMI showed a significant independent, negative linear correlation with the public distress domain of preoperative quality of life (QOL) (r = -0.368, p = 0.001; β = -0.245, p = 0.009). Preoperative BMI had a significant, positive and independent association with EWL-1 year (r = 0.499, p = 0.009; β = 0.679, p = 0.015). Preoperative QOL scores had no association with EWL-1 year.


CONCLUSIONS
Preoperative BMI appears to predict EWL-1 year following restrictive bariatric surgery (LAGB). Preoperatively, patients with higher BMI appear to manifest greater public distress. Preoperative QOL scores, however, do not appear to have any predictive value for EWL-1 year post-LAGB. Preoperative BMI should therefore be employed as a predictor of EWL-1 year post-LAGB. Other measures of successful outcomes of bariatric surgeries (such as effects on QOL scores at 1 year) should be explored in future, larger and longer term studies.
Division of Metabolic and Vascular Health, Warwick Medical School, The University of Warwick, Clinical Sciences Research Laboratories, Clinical Sciences Building, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, UK.
S A
SA
Saboor Aftab
L
L
Halder
M K
MK
Piya
N
N
Reddy
I
I
Fraser
V
V
Menon
S
S
Bridgwater
D
D
Kendrick
S
S
Kumar
T M
TM
Barber
D000328:Adult; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011184:Postoperative Period; D011788:Quality of Life; D016896:Treatment Outcome; D015431:Weight Loss