Comparative Outcomes of Bariatric Surgery in Patients with Impaired Mobility and Ambulatory Population
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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.
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.
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.
KeywordsBariatric surgery Impaired mobility Sleeve gastrectomy Roux-en-Y gastric bypass Metabolic outcomes Wheelchair bound Non-ambulatory
Compliance with Ethical Standards
For this type of study, formal consent is not required
This study does not require informed consent.
Conflict of Interest
The authors declare that they have no conflict of interest.
- 3.Peytremann-Bridevaux I, Santos-Eggimann B. Health correlates of overweight and obesity in adults aged 50 years and over: results from the Survey of Health, Ageing and Retirement in Europe (SHARE). Obesity and health in Europeans aged ≥ or = 50 years. Swiss Med Wkly. 2008;138(17–18):261–6.PubMedGoogle Scholar
- 24.Harrell FE Jr. Hmisc: Harrell Miscellaneous. R package version 3.17-0. 2015. https://CRAN.R-project.org/package=Hmisc.
- 26.Livingston EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg. 2002;236(5):576–82. https://doi.org/10.1097/01.SLA.0000033321.22614.D6.CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Sekhon JS. Multivariate and propensity score matching software with automated balance optimization: the matching package for R. J Stat Softw. 2011;42(7). https://doi.org/10.18637/jss.v042.i07.
- 31.R Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2015.Google Scholar
- 32.Santry HP, Lauderdale DS, Cagney KA, et al. Predictors of patient selection in bariatric surgery. Ann Surg. 2007;245(1):59–67. https://doi.org/10.1097/01.sla.0000232551.55712.b3.CrossRefPubMedPubMedCentralGoogle Scholar