Preoperative Depression Status and 5 Year Metabolic and Bariatric Surgery Outcomes in the PCORnet Bariatric Study Cohort. Issue 4 (19th April 2023)

• Record Type: Journal Article
• Authors: 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.; Fitzpatrick, Stephanie L.; Desai, Jay R.; Murali, Sameer; Morrow, Ellen H.; Rogers, Ann M.; Wood, G. Craig; Schlundt, David G.; Apovian, Caroline M.; Duke, Meredith C.; McClay, James C.; Soans, Rohit; Nemr, Rabih; Williams, Neely; Courcoulas, Anita; Holmes, John H.; Anau, Jane; Toh, Sengwee; Sturtevant, Jessica L.; Horgan, Casie E.; Cook, Andrea J.; Arterburn, David E.;
• Other Names: Coughlin Janelle W. author non-byline.; Bennett Wendy L. author non-byline.; Nauman Elizabeth author non-byline.; Wellman Robert author non-byline.; Coley R. Yates author non-byline.; Anau Jane author non-byline.; Cook Andrea J. author non-byline.; Arterburn David author non-byline.; McTigue Kathleen M. author non-byline.; Courcoulas Anita author non-byline.; Toh Sengwee author non-byline.; Sturtevant Jessica L author non-byline.; Horgan Casie E. author non-byline.; Brown Jeffrey S. author non-byline.; Coleman Karen J. author non-byline.; Jones Daniel B. author non-byline.; Wee Christina C. author non-byline.; Lewis Kristina H author non-byline.; Tobin Jonathan N. author non-byline.; Fitzpatrick Stephanie L. author non-byline.; Desai Jay R. author non-byline.; Murali Sameer author non-byline.; Morrow Ellen H. author non-byline.; Conroy Molly B. author non-byline.; Rogers Ann M. author non-byline.; Kraschnewski Jennifer L. author non-byline.; Woods G. Craig author non-byline.; Still Christopher D. author non-byline.; Schlundt David J. author non-byline.; McClay James C. author non-byline.; McBride Corrigan L. author non-byline.; Soans Rohit author non-byline.; Duke Meredith C. author non-byline.; Blalock Cynthia author non-byline.; Nemr Rabih author non-byline.; Williams Neely author non-byline.; Emiliano Ana B. author non-byline.; Xanthakos Stavra A. author non-byline.; Inge Thomas author non-byline.; Carey Timothy S author non-byline.; Michalsky Marc author non-byline.; Daley Matthew F. author non-byline.; Gordon Howard S. author non-byline.; Reichard Kirk W. author non-byline.; Apovian Caroline M. author non-byline.; Tavakkoli Ali author non-byline.; Adams William G. author non-byline.; Holmes John H. author non-byline.;
• Is Part Of: Annals of surgery. Volume 277:Issue 4(2023)
• Page Start: 637
• Page End: 646
• Publication Date: 2023-04-19
• Subjects: bariatric surgery -- cohort -- depression -- longitudinal -- outcomes -- psychiatric -- psychosocial; Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000005364
• Languages: English
• ISSNs: 0003-4932

Abstract

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.