Comparative Outcomes of Bariatric Surgery in Patients with Impaired Mobility and Ambulatory Population

  • Gautam Sharma
  • Zubaidah Nor-Hanipah
  • Ivy N. Haskins
  • Suriya Punchai
  • Andrew T. Strong
  • Chao Tu
  • John H. Rodriguez
  • Phillip R. Schauer
  • Matthew Kroh
Original Contributions
  • 32 Downloads

Abstract

Purpose

This study aims to characterize complications, metabolic improvement, and change in ambulation status for patients with impaired mobility undergoing bariatric surgery.

Material and Methods

Individuals undergoing primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) from February 2008 to December 2015 were included. Impaired mobility (WC) was defined as using a wheelchair or motorized scooter for at least part of a typical day. The WC group was propensity score matched to ambulatory patients (1:5 ratio). Comparisons were made for 30-day morbidity and mortality and 1-year improvement in weight-related comorbidities.

Results

There were 93 patients in the WC group matched to 465 ambulatory controls. The median operative time (180 vs 159 min, p = 0.003) and postoperative length of stay (4 vs 3 days, p ≤ 0.001) was higher in the WC group. There were no differences in readmission or all-cause morbidity within 30 days. The median percent excess weight loss (%EWL) at 1 year was similar (WC group, 65% available, 53% EWL vs AMB group, 73% available, 54% EWL); however, patients with impaired mobility were less likely to experience improvement in diabetes (76 vs 90%, p = 0.046), hypertension (63 vs 82%, p < 0.005), and obstructive sleep apnea (53 vs 71%, p < 0.001). Within the WC group, 62% had improvement in their mobility status, eliminating dependence on wheelchair or scooter assistance.

Conclusion

Patients with both obesity and impaired mobility experience similar rates of perioperative morbidity and weight loss at 1 year compared to ambulatory controls. However, improvement in weight-related comorbidities may be less likely with impaired mobility.

Keywords

Bariatric surgery Impaired mobility Sleeve gastrectomy Roux-en-Y gastric bypass Metabolic outcomes Wheelchair bound Non-ambulatory 

Notes

Compliance with Ethical Standards

Ethical Approval

For this type of study, formal consent is not required

Informed Consent

This study does not require informed consent.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Gautam Sharma
    • 1
  • Zubaidah Nor-Hanipah
    • 2
    • 3
  • Ivy N. Haskins
    • 1
  • Suriya Punchai
    • 2
    • 4
  • Andrew T. Strong
    • 1
    • 5
  • Chao Tu
    • 1
    • 6
  • John H. Rodriguez
    • 1
    • 2
    • 5
  • Phillip R. Schauer
    • 2
    • 5
  • Matthew Kroh
    • 1
    • 2
    • 5
    • 7
  1. 1.Section of Surgical Endoscopy, Digestive Disease and Surgery InstituteCleveland ClinicClevelandUSA
  2. 2.Bariatric and Metabolic InstituteCleveland ClinicClevelandUSA
  3. 3.Department of Surgery, Faculty of Medicine and Health SciencesUniversity Putra MalaysiaSeri KembanganMalaysia
  4. 4.Department of Surgery, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
  5. 5.Cleveland Clinic Lerner College of Medicine of Case Western Reserve UniversityClevelandUSA
  6. 6.Quantitiatve Health SciencesCleveland ClinicClevelandUSA
  7. 7.Digestive Disease InstituteCleveland Clinic Abu DhabiAbu DhabiUAE

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