期刊
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
卷 9, 期 3, 页码 228-233出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2010.11.004
关键词
Weight Loss; Obesity; Surgery; ROC; PPV
资金
- NIDDK NIH HHS [T32 DK007533, T32 DK007191, T32DK007191, P30 DK034854, T32 DK007191-36] Funding Source: Medline
BACKGROUND & AIMS: Weight regain after Roux-en-Y gastric bypass (RYGB) is associated with reductions in health status and quality of life. We evaluated whether gastrojejunal stoma diameter is a risk factor for weight regain after RYGB. METHODS: We examined data collected over 4 years from consecutive patients referred to a tertiary care bariatric center for upper endoscopy after RYGB. We used linear regression analysis to determine the association between the gastrojejunal stoma diameter and weight regain. We applied a logistic regression model using clinical and endoscopic parameters to develop a prediction rule for weight gain after RYGB. RESULTS: Among 165 patients included in our study, 59% had significant weight regain (>= 20% of maximum weight lost after the RYGB) and 41% did not. The mean percentage of maximal weight lost after RYGB that was regained in the entire cohort was 30% +/- 22%. Gastrojejunal stoma diameter was associated significantly with weight regain after RYGB surgery in univariate analysis (beta = .31, P < .0001). This association remained significant after adjusting for several known or purported risk factors for weight regain (beta = .19, P = .003). We developed a simple prediction rule for weight regain after RYGB using a 7-point scoring system that includes the gastrojejunal stoma diameter, race, and percentage of maximal body weight lost after RYGB; a cut-off score of 4 or more points had an area under receiver operating characteristic curve of 0.76 and a positive predictive value of 75%. CONCLUSIONS: Increased gastrojejunal stoma diameter is a risk factor for weight regain after RYGB and can be incorporated in a novel prediction rule.
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