Beyond weight loss after sleeve gastrectomy: improvement in health-related quality of life

Yıl 2019, Cilt: 5 Sayı: 1, 29 - 35, 04.01.2019

Evren Dilektaşlı

https://doi.org/10.18621/eurj.413959

Öz

Objectives: Obesity and
related diseases are increasing and with the bariatric procedures both the
excess weight and the prevalence of these related diseases are decreasing. Both
obesity and related diseases lead to impairment on health-related quality of
life of the patients. We aimed to evaluate the short-term effects of sleeve
gastrectomy operation on health related quality of life in patients that were
operated for morbid obesity.

Methods: Prospectively 62 patients
that had sleeve gastrectomy operation enrolled in the study. The percentage of
excess weight loss (%EWL) and the percentage of excess BMI loss (%EBMIL) were
calculated 6 months after the operation. Anthropometric data and
obesity-related co-morbidities were recorded. SF-36 questionnaire was used in
order to evaluate the general health quality of the patients.

Results: The mean age of the patients was 37 years and the majority of the patients
were female (74.2%). At the postoperative 6^th month, mean %EWL was
calculated as 52.7% and mean %EBMIL was 60.1%. Six months after the
operation, with the significant weight loss achieved, obesity-related
co-morbidities were improved. Short Form-36 subscale scores at 6 months following the operation
were observed, when compared with the preoperative scores (all p< 0.001). The mean physical health
score significantly improved from 46.1 to 83.6 and the median mental health
improved from 52 to 84, just 6 months after the sleeve gastrectomy operation. In
multiple regression analysis %EWL was found to be a significant determinant of DMental
health (B coefficient 0.490, p = 0.025) and D Physical health (B coefficient 0.388, p = 0.047) after adjusting for gender, age, smoking, obstructive sleep apnea
syndrome, hypertension, diabetes
mellitus and coronary disease.

Conclusions: With the successive
weight loss after sleeve gastrectomy, at the postoperative 6^th month,
the physical and mental health-related quality of life was significantly
improved. Early and expedited regain of this quality of life after the
operation is important for the patients and their social surroundings. Moreover
it is important for the countries to decrease the medical expenses and increase
labour productivity. 

Anahtar Kelimeler

Sleeve gastrectomy, quality of life, SF-36

Kaynakça

• [1] Statistics NCfH. Health, United States, 2014: with special feature on adults aged 55-64. 2015.
• [2] Erem C. Prevalence of overweight and obesity in Turkey. IJC Metab Endocr 2015;8:38-41.
• [3] Organization WH. World health statistics 2016: monitoring health for the SDGs sustainable development goals: World Health Organization; 2016.
• [4] Simonson DC, Halperin F, Foster K, Vernon A, Goldfine AB. Clinical and Patient-Centered Outcomes in Obese Patients With Type 2 Diabetes 3 Years After Randomization to Roux-en-Y Gastric Bypass Surgery Versus Intensive Lifestyle Management: The SLIMM-T2D Study. Diabetes Care. 2018;41:670-9.
• [5] Monteiro F, Ponce DA, Silva H, Pitta F, Carrilho AJ. Physical function, quality of life, and energy expenditure during activities of daily living in obese, post-bariatric surgery, and healthy subjects. Obes Surg 2017;27:2138-44.
• [6] Busetto L, Mozzi E, Schettino AM, Furbetta F, Giardiello C, Micheletto G, et al. Three years durability of the improvements in health-related quality of life observed after gastric banding. Surg Obes Relat Dis 2015;11:110-7.
• [7] Pinar R. Reliability and construct validity of the SF-36 in Turkish cancer patients. Qual Life Res 2005;14:259-64.
• [8] Demiral Y, Ergor G, Unal B, Semin S, Akvardar Y, Kıvırcık B, et al. Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population. BMC Public Health 2006;6:247.
• [9] Kasapoğlu Aksoy M, Altan L, Güner A. The effectiveness of soft and semi-rigid cervical collars on acute cervical radiculopathy. Eur Res J 2018;4:16-25.
• [10] Fezzi M, Kolotkin RL, Nedelcu M, Jaussent A, Schaub R, Chauvet MA, et al. Improvement in quality of life after laparoscopic sleeve gastrectomy. Obes Surg 2011;21:1161-7.
• [11] Major P, Matłok M, Pędziwiatr M, Migaczewski M, Budzyński P, Stanek M, et al. Quality of life after bariatric surgery. Obes Surg 2015;25:1703-10.
• [12] Height M, Tables W. Metropolitan life foundation. Stat Bull 1983;64:2-9.
• [13] Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 1992,30:473-83.
• [14] Gagner M, Hutchinson C, Rosenthal R. Fifth International Consensus Conference: current status of sleeve gastrectomy. Surg Obes Relat Dis 2016;12:750-6.
• [15] Nocca D, Krawczykowsky D, Bomans B, Noël P, Picot M, Blanc P, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg 2008;18:560-5.
• [16] Nikolić M, Kruljac I, Kirigin L, Mirošević G, Ljubičić N, Nikolić BP, et al. Initial weight loss after restrictive bariatric procedures may predict mid-term weight maintenance: results from a 12-month pilot trial. Bariatr Surg Pract Patient Care 2015;10:68-73.
• [17] Zeller MH, Inge TH, Modi AC, Jenkins TM, Michalsky MP, Helmrath M, et al. Severe obesity and comorbid condition impact on the weight-related quality of life of the adolescent patient. J Pediatr 2015;166:651-9.e4.
• [18] Dillon C, Peddle J, Twells L, Lester K, Midodzi W, Manning K, et al. Rapid reduction in use of antidiabetic medication after laparoscopic sleeve gastrectomy: The Newfoundland and Labrador Bariatric Surgery Cohort (BaSCo) Study. Can J Hosp Pharm 2015;68:113.
• [19] Bobowicz M, Lehmann A, Orlowski M, Lech P, Michalik M. Preliminary outcomes 1 year after laparoscopic sleeve gastrectomy based on Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg 2011;21:1843-8.
• [20] Ryan KK, Tremaroli V, Clemmensen C, Kovatcheva-Datchary P, Myronovych A, Karns R, et al. FXR is a molecular target for the effects of vertical sleeve gastrectomy. Nature 2014;509:183-8.
• [21] Jia H, Zack MM, Thompson WW, Dube SR. Quality-adjusted life expectancy (QALE) loss due to smoking in the United States. Qual Life Res 2013;22:27-35.
• [22] Charalampakis V, Bertsias G, Lamprou V, de Bree E, Romanos J, Melissas J. Quality of life before and after laparoscopic sleeve gastrectomy. A prospective cohort study. Surg Obes Relat Dis 2015;11:70-6.
• [23] Raaijmakers L, Pouwels S, Thomassen S, Nienhuijs S. Quality of life and bariatric surgery: a systematic review of short-and long-term results and comparison with community norms. Eur J Clin Nutr 2017;71:441-9.