Impact of Age, Sex and Body Mass Index on Outcomes at Four Years after Gastric Banding
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Background: Adjustable gastric banding for weight reduction in severely obese persons allows reversible individualized restriction during postoperative follow-up. It is unknown whether preoperative age, sex and BMI might modulate treatment outcome. Methods: 404 severely obese patients (79% women; age 42±0.5 years [mean±SEM]; BMI 42.1±0.2 kg/m2) completed 4-year follow-up after banding. Weight loss, complications, and Bariatric Analysis and Reporting Outcome System (BAROS) scores were recorded prospectively. Results: 4 years after banding, younger (<50 years) women lost more weight than older (≥50 years) men (28.2±0.7 % vs 19.4±1.6 %; P=0.001); older women and younger men lost similar weight. Patients with preoperative BMI >50 lost more weight than patients with BMI <35 (30.5±2.3 % vs 22.8±2.6 %; P=0.03). 22.3% of patients (n=90) had band system-related complications. Compared to women, men had more band leaks (7.0% vs 1.9%; P=0.007), and older men had more band slippages than younger men (8.4% vs 0.0%; P=0.035). Patients with preoperative BMI >50 were less likely than patients with BMI 35–40 or 40–50 to experience gastric complications (10.6%, 18.8%, 23.0%, respectively), but more likely to experience port/tube complications (15.8%, 2.4%, 7.9%, respectively; P<0.055). BAROS scores were different between men and women (P=0.05), and between younger and older people (P =0.001). Women and younger people were more likely than men and older people to score "very good" (P=0.03, P=0.001, respectively). Conclusions: Adjustable gastric banding is an effective intermediate-term treatment for severe obesity. Preoperative age, sex, and BMI are important modulators of outcome and should be considered during preoperative evaluation.
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