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. 2021 May;31(5):1979-1985.
doi: 10.1007/s11695-020-05186-9. Epub 2021 Jan 11.

Where Are My Patients? Lost and Found in Bariatric Surgery

Paolino Luca  1 , Couteau Nicolas  2 , Vignot Marina  2 , Batahei Sarah  2 , Lazzati Andrea  2   3
Affiliations

Where Are My Patients? Lost and Found in Bariatric Surgery

Paolino Luca et al. Obes Surg. 2021 May.

Abstract

Purpose: Follow-up is a cornerstone of the success of bariatric surgery. However, adherence to monitoring decreases over time. The reasons for non-compliance with follow-up still remain unclear.

Materials and methods: This is a retrospective, single-center, cohort study, including all patients undergoing bariatric surgery between 2014 and 2017. Patients lost to follow-up were called back and questioned about the reasons of non-adherence. Patients followed and lost to follow-up were compared in terms of weight loss.

Results: Overall, 29.7% of patients were lost to follow-up. After a callback, we obtained information on 89.9% of patients. The first reason of non-attendance was considering follow-up as unnecessary (29.5%). Almost a quarter of patients (24%) discontinued follow-up due to geographic distance, while 23.3%, 18.6%, and 14.0% of patients explained the lack of follow-up due to family, professional, or health problems. Only 7.0% declared to renounce to follow-up because of poor weight loss. Percentage of excess weight loss at 3 and 5 years after surgery was respectively 73.6% and 81.2% in attendant patients, and 70.7% and 68.4% in non-adherent patients (p = ns). Despite a greater weight loss in the group of patients regularly followed, the difference with patients lost to follow-up remained not significant in multivariate analysis.

Conclusions: Follow-up is of crucial importance in the management of bariatric patients. Follow-up disruption is associated to individual patient choice and external constraints. In order to improve the quality of long-term care, care providers will probably need to adapt to these constraints, diversifying the offer of care.

Keywords: Attrition; Follow-up; Obesity surgery.

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