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Preoperative Depression Status and 5 Year Metabolic and Bariatric Surgery Outcomes in the PCORnet Bariatric Study Cohort
Coughlin, Janelle W. Nauman, Elizabeth Wellman, Robert Coley, R. Yates McTigue, Kathleen M. Coleman, Karen J. Jones, Daniel B. Lewis, Kristina H. Tobin, Jonathan N. Wee, Christina C.
Coughlin, Janelle W.
Nauman, Elizabeth
Wellman, Robert
Coley, R. Yates
McTigue, Kathleen M.
Coleman, Karen J.
Jones, Daniel B.
Lewis, Kristina H.
Tobin, Jonathan N.
Wee, Christina C.
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Journal article
Date
2022-01-19
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Department
Surgery
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DOI
http://dx.doi.org/10.1097/sla.0000000000005364
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.
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Lippincott, Williams & Wilkins
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Annals of Surgery, Vol. 277, No. 4
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