Abstract
Objective: To examine whether depression status before metabolic and bariatric surgery (MBS) influenced 5-year weight loss, diabetes, and safety/utilization outcomes in the PCORnet Bariatric Study. Summary of Background Data: Research on the impact of depression on MBS outcomes is inconsistent with few large, long-term studies. Methods: Data were extracted from 23 health systems on 36,871 patients who underwent sleeve gastrectomy (SG; n=16,158) or gastric bypass (RYGB; n=20,713) from 2005-2015. Patients with and without a depression diagnosis in the year before MBS were evaluated for % total weight loss (%TWL), diabetes outcomes, and postsurgical safety/utilization (reoperations, revisions, endoscopy, hospitalizations, mortality) at 1, 3, and 5 years after MBS. Results: 27.1% of SG and 33.0% of RYGB patients had preoperative depression, and they had more medical and psychiatric comorbidities than those without depression. At 5 years of follow-up, those with depression, versus those without depression, had slightly less %TWL after RYGB, but not after SG (between group difference = 0.42%TWL, P = 0.04). However, patients with depression had slightly larger HbA1c improvements after RYGB but not after SG (between group difference = - 0.19, P = 0.04). Baseline depression did not moderate diabetes remission or relapse, reoperations, revision, or mortality across operations; however, baseline depression did moderate the risk of endoscopy and repeat hospitalization across RYGB versus SG. Conclusions: Patients with depression undergoing RYGB and SG had similar weight loss, diabetes, and safety/utilization outcomes to those without depression. The effects of depression were clinically small compared to the choice of operation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 637-646 |
| Number of pages | 10 |
| Journal | Annals of surgery |
| Volume | 277 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2023 |
Funding
Funding: The PCORnet Study reported in this publication was conducted using PCORnet, the National Patient-Centered Clinical Research Network. PCORnet has been developed with funding from the Patient-Centered Outcomes Research Institute (PCORI). Dr. Arterburn received travel support from the World Congress for Interventional Therapy for Diabetes and the IFSO Latin America Chapter during the conduct of the study. Dr Courcoulas reports grants from Covidien/Ethicon Johnson & Johnson, during the conduct of the study. Dr Jones reports personal fees from Allurion. Dr. Apovian reports personal fees from Nutrisystem, Zafgen, Sanofi- Aventis, Orexigen, Novo Nordisk, GI Dynamics, Takeda, Scientific Intake, Xeno Biosciences, Rhythm Pharmaceuticals, Eisai, EnteroMedics, and Baria- trix Nutrition outside the submitted work; grants from Orexigen, Aspire Bariatrics, GI Dynamics, Myos, Takeda, the Vela Foundation, the Dr. Robert C. and Veronica Atkins Foundation, Coherence Lab, Energesis, and the National Institutes of Health outside the submitted work; and past ownership of stock in Science-Smart LLC. Dr. Fitzpatrick reports financial support from WW (formerly Weight Watchers) outside the submitted work. Dr. Coleman receives funding from Janssen and the Food and Drug Administration outside the submitted work. This study was funded by the PCORI via contract OBS-1505-30683. Dr. Arterburn received travel support from the World Congress for Interventional Therapy for Diabetes and the IFSO Latin America Chapter during the conduct of the study. Dr Courcoulas reports grants from Covidien/Ethicon Johnson & Johnson, during the conduct of the study. Dr Jones reports personal fees from Allurion. Dr. Apovian reports personal fees from Nutrisystem, Zafgen, Sanofi- Aventis, Orexigen, Novo Nordisk, GI Dynamics, Takeda, Scientific Intake, Xeno Biosciences, Rhythm Pharmaceuticals, Eisai, EnteroMedics, and Baria- trix Nutrition outside the submitted work; grants from Orexigen, Aspire Bariatrics, GI Dynamics, Myos, Takeda, the Vela Foundation, the Dr. Robert C. and Veronica Atkins Foundation, Coherence Lab, Energesis, and the National Institutes of Health outside the submitted work; and past ownership of stock in Science-Smart LLC. Dr. Fitzpatrick reports financial support from WW (formerly Weight Watchers) outside the submitted work. Dr. Coleman receives funding from Janssen and the Food and Drug Administration outside the submitted work.
Keywords
- bariatric surgery
- cohort
- depression
- longitudinal
- outcomes
- psychiatric
- psychosocial
ASJC Scopus subject areas
- Surgery
