Introduction: LAGB has been proved to be associated with successful weight loss and weight maintenance, improvement of obesity-related comorbidities and reduced all-cause mortality. Initial observations demonstrated an improvement of HR-QoL after LAGB. However, determinants of changes in HR-QoL after bariatric surgery have been seldom investigated. In this study, we analyzed HR-QoL and its determinants in the first year after LAGB. Methods: We used data collected in the first year of the QUALITY study, a prospective 3-year multicenter Italian study on changes of HR-QoL in obese patients treated with LAGB. Inclusion criteria were BMI³40 kg/m2 (BMI³35 kg/m2 if complicated obesity) and age 18–60 years. HR-QoL was investigated with the SF-36 questionnaire. Side effects, hunger, satiety and the self-perceived effects of LAGB were determined with a specific questionnaire. Results: 334 patients (74 M and 260 F) were enrolled at 10 Italian bariatric centres. Age at surgery was 38.9±10.1 years. BMI was 41.7±5.6 kg/m2. Follow-up rate was 97.0% at 6 months and 92.2% at 12 months. %EWL was 29.2±15.9% at 6 m. and 39.6±25.8% at 12 m., with very few side effects and complications. Hunger at morning (evaluated on a 0–10 scale) was 4.5±2.7 before surgery, 4.0±2.4 at 6 m. (p<0.001) and 3.8±2.4 at 12 m. (p<0.05 vs 6 m.). Satiety after meal was rated (0–10 scale) 7.1±2.7 before surgery, 7.9±8.2 at 6 m. (p<0.001) and 8.2±1.9 at 12 m. (p<0.01 vs 6 m.). The self-perceived effect of LAGB on own caloric intake (0–10 scale) was 8.0±2.1 at 6 m. and 8.4±1.9 at 12 m. Scores in the 8 SF-36 subscales were lower than in the general Italian population before surgery and significant improvements in all the 8 subscales were observed both at 6 and at 12 m. after. Physical component summary score (PCS) was 52.6±11.9 at baseline, 75.3±19.9 at 6 m. (p<0.001) and 79.1±15.6 at 12 m. (p<0.001 vs 6 m.). Mental component (MCS) was 52.2±12.3, 73.2±18.2 (p<0.001) and 76.5±17.2 (p<0.001) respectively. Determinants of the 0–12 months improvements in PCS and MCS were analysed by multiple stepwise regression analysis. A higher PCS improvement was associated to a lower initial PCS (p<0.001), to a higher satiety after meal (p=0.002), to a higher %EWL (p=0.013) and to a higher self-perceived effect of the LAGB (p=0.026). A higher MCS improvement was associated to a lower initial MCS (p<0.001), to a higher satiety after meal (p<0.001), to a lower frequency of heartburn (p=0.004) and to a higher %EWL (p=0.012). No significant associations were observed between the improvements of PCS or MCS and sex, age, initial BMI, BMI at 12 months, baseline eating behaviour, baseline comorbidities, and the improvements of comorbidities after 12 months. Conclusion: Significant improvements of HR-QoL were observed in the first year after LAGB. Poor baseline HR-QoL, high efficacy of the banding in eating control and better weight loss may influence HR-QoL changes.

Improvement in health-related quality of Life (HR-QOL) in the first year after laparoscopic adjustable gastric banding (LAGB) / E. Mozzi, A. Schettino, V. Pilone, F. Furbetta, A. Di Maro, C. Giardiello, M. Battistoni, A. Gardinazzi, G. Micheletto, N. Perrotta, L. Busetto. - In: OBESITY SURGERY. - ISSN 0960-8923. - 21:8(2011), pp. 1044-1044. ((Intervento presentato al 14. convegno World Congress of IFSO tenutosi a Hamburg nel 2011 [10.1007/s11695-011-0435-9].

Improvement in health-related quality of Life (HR-QOL) in the first year after laparoscopic adjustable gastric banding (LAGB)

E. Mozzi;G. Micheletto;
2011

Abstract

Introduction: LAGB has been proved to be associated with successful weight loss and weight maintenance, improvement of obesity-related comorbidities and reduced all-cause mortality. Initial observations demonstrated an improvement of HR-QoL after LAGB. However, determinants of changes in HR-QoL after bariatric surgery have been seldom investigated. In this study, we analyzed HR-QoL and its determinants in the first year after LAGB. Methods: We used data collected in the first year of the QUALITY study, a prospective 3-year multicenter Italian study on changes of HR-QoL in obese patients treated with LAGB. Inclusion criteria were BMI³40 kg/m2 (BMI³35 kg/m2 if complicated obesity) and age 18–60 years. HR-QoL was investigated with the SF-36 questionnaire. Side effects, hunger, satiety and the self-perceived effects of LAGB were determined with a specific questionnaire. Results: 334 patients (74 M and 260 F) were enrolled at 10 Italian bariatric centres. Age at surgery was 38.9±10.1 years. BMI was 41.7±5.6 kg/m2. Follow-up rate was 97.0% at 6 months and 92.2% at 12 months. %EWL was 29.2±15.9% at 6 m. and 39.6±25.8% at 12 m., with very few side effects and complications. Hunger at morning (evaluated on a 0–10 scale) was 4.5±2.7 before surgery, 4.0±2.4 at 6 m. (p<0.001) and 3.8±2.4 at 12 m. (p<0.05 vs 6 m.). Satiety after meal was rated (0–10 scale) 7.1±2.7 before surgery, 7.9±8.2 at 6 m. (p<0.001) and 8.2±1.9 at 12 m. (p<0.01 vs 6 m.). The self-perceived effect of LAGB on own caloric intake (0–10 scale) was 8.0±2.1 at 6 m. and 8.4±1.9 at 12 m. Scores in the 8 SF-36 subscales were lower than in the general Italian population before surgery and significant improvements in all the 8 subscales were observed both at 6 and at 12 m. after. Physical component summary score (PCS) was 52.6±11.9 at baseline, 75.3±19.9 at 6 m. (p<0.001) and 79.1±15.6 at 12 m. (p<0.001 vs 6 m.). Mental component (MCS) was 52.2±12.3, 73.2±18.2 (p<0.001) and 76.5±17.2 (p<0.001) respectively. Determinants of the 0–12 months improvements in PCS and MCS were analysed by multiple stepwise regression analysis. A higher PCS improvement was associated to a lower initial PCS (p<0.001), to a higher satiety after meal (p=0.002), to a higher %EWL (p=0.013) and to a higher self-perceived effect of the LAGB (p=0.026). A higher MCS improvement was associated to a lower initial MCS (p<0.001), to a higher satiety after meal (p<0.001), to a lower frequency of heartburn (p=0.004) and to a higher %EWL (p=0.012). No significant associations were observed between the improvements of PCS or MCS and sex, age, initial BMI, BMI at 12 months, baseline eating behaviour, baseline comorbidities, and the improvements of comorbidities after 12 months. Conclusion: Significant improvements of HR-QoL were observed in the first year after LAGB. Poor baseline HR-QoL, high efficacy of the banding in eating control and better weight loss may influence HR-QoL changes.
Settore MED/18 - Chirurgia Generale
2011
Article (author)
File in questo prodotto:
File Dimensione Formato  
art%3A10.1007%2Fs11695-011-0435-9.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 3.33 MB
Formato Adobe PDF
3.33 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/197844
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? 0
social impact