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

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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.

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Authors and Affiliations

  1. Section of Surgical Endoscopy, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA

    Gautam Sharma, Ivy N. Haskins, Andrew T. Strong, Chao Tu, John H. Rodriguez & Matthew Kroh

  2. Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA

    Zubaidah Nor-Hanipah, Suriya Punchai, John H. Rodriguez, Phillip R. Schauer & Matthew Kroh

  3. Department of Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Seri Kembangan, Selangor, Malaysia

    Zubaidah Nor-Hanipah

  4. Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Suriya Punchai

  5. Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA

    Andrew T. Strong, John H. Rodriguez, Phillip R. Schauer & Matthew Kroh

  6. Quantitiatve Health Sciences, Cleveland Clinic, Cleveland, OH, USA

    Chao Tu

  7. Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE

    Matthew Kroh

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  1. Gautam Sharma
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Correspondence to Matthew Kroh.

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The authors declare that they have no conflict of interest.

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Sharma, G., Nor-Hanipah, Z., Haskins, I.N. et al. Comparative Outcomes of Bariatric Surgery in Patients with Impaired Mobility and Ambulatory Population. OBES SURG 28, 2014–2024 (2018). https://doi.org/10.1007/s11695-018-3132-0

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  • DOI: https://doi.org/10.1007/s11695-018-3132-0

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