• Janelle W Coughlin, Elizabeth Nauman, Robert Wellman, R Yates Coley, Kathleen M McTigue, Karen J Coleman, Daniel B Jones, Kristina H Lewis, Jonathan N Tobin, Christina C Wee, Stephanie L Fitzpatrick, Jay R Desai, Sameer Murali, Ellen H Morrow, Ann M Rogers, G Craig Wood, David G Schlundt, Caroline M Apovian, Meredith C Duke, James C McClay, Rohit Soans, Rabih Nemr, Neely Williams, Anita Courcoulas, John H Holmes, Jane Anau, Sengwee Toh, Jessica L Sturtevant, Casie E Horgan, Andrea J Cook, David E Arterburn, and PCORnet Bariatric Study Collaborative.
• Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD.
• Ann. Surg. 2023 Apr 1; 277 (4): 637646637-646.

ObjectiveTo 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 DataResearch on the impact of depression on MBS outcomes is inconsistent with few large, long-term studies.MethodsData 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.Results27.1% 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.ConclusionsPatients 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.Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.

20 keywords...

hide…