Background

Adequate long-term follow-up after metabolic and bariatric surgery (MBS) remains a challenge.

Objectives

To evaluate if type of insurance correlated with differences in the 5-year follow-up and outcomes of a cohort of bariatric surgery patients in a community-based accredited center.

Setting

Accredited private practice bariatric center in the United States.

Methods

We studied bariatric surgery patients that underwent MBS in 2015 by a single surgeon in an accredited, community practice. Electronic medical records were utilized to evaluate 5-year follow-up and outcomes data. This included demographics, type of insurance, number of follow-up visits, height, weight, body mass index (BMI), postbariatric procedures, and postbariatric emergency department (ED) utilization.

Results

There were 89 patients. The follow-up rate decreased over time, with 1% of patients at 5 years. There was a slightly higher follow-up rate in patients with commercial versus public insurance. The average BMI of patients that followed up decreased by 13.6 kg/m² over the first postoperative year. The average number of ED visits was 1.46 (standard deviation: 2.38) overall; however, of the 89 total patients, 35 patients (39.3%) had no documented ED visits, with the remaining 61 patients (63.5%) ranging from 1–15 visits (median = 1).

Conclusion

Overall follow-up rates were low with 4-year follow-up being 14% and 5-year follow-up being <1%. Publicly insured patients had a higher rate of follow-up. Despite low follow-up rates with the actual bariatric surgery practice, 63.5% of patients had an ED visit during the follow-up period.

中文翻译：

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在经认可的社区减肥诊所进行 5 年随访：可接受的随访率是多少？

背景

代谢和减肥手术 (MBS) 后进行充分的长期随访仍然是一个挑战。

目标

评估保险类型是否与社区认可中心的减肥手术患者队列的 5 年随访和结果差异相关。

环境

美国认可的私人执业减肥中心。

方法

我们研究了 2015 年由一名外科医生在认可的社区实践中接受 MBS 的减肥手术患者。电子病历用于评估 5 年的随访和结果数据。这包括人口统计、保险类型、随访次数、身高、体重、体重指数 (BMI)、减肥后手术和减肥后急诊科 (ED) 的利用率。

结果

有89名患者。随访率随着时间的推移而下降，5 年时有 1% 的患者。商业保险患者与公共保险患者的随访率略高。术后第一年随访患者的平均BMI下降了13.6 kg/m ²。急诊就诊的平均次数为 1.46（标准差：2.38）；然而，在 89 名患者中，35 名患者 (39.3%) 没有记录在案的 ED 就诊，其余 61 名患者 (63.5%) 的就诊次数为 1-15 次（中位数 = 1）。

结论

总体随访率较低，4 年随访率为 14%，5 年随访率<1%。公共保险患者的随访率更高。尽管实际减肥手术的随访率很低，但 63.5% 的患者在随访期间进行了 ED 就诊。