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. 2022 Dec 1;276(6):e792-e797.
doi: 10.1097/SLA.0000000000004841. Epub 2021 Mar 1.

Patient-reported Comorbidity Assessment After Bariatric Surgery: A Potential Tool to Improve Longitudinal Follow-up

Grace F Chao  1   2   3 , Aaron J Bonham  4 , Rachel Ross  4 , Amanda Stricklen  4 , Amir A Ghaferi  4   5
Affiliations

Patient-reported Comorbidity Assessment After Bariatric Surgery: A Potential Tool to Improve Longitudinal Follow-up

Grace F Chao et al. Ann Surg. .

Abstract

Objective: To determine the accuracy of postoperative patient-reported comorbidity assessment, as it may be an important mechanism for long-term follow-up in surgical patients.

Summary of background data: Less than 1% of patients who qualify actually undergo bariatric surgery which may be due to concerns surrounding long-term efficacy. Longitudinal follow-up of patients' comorbidities remains a challenge.

Methods: Retrospective, cross-sectional study of bariatric surgery patients from 38 sites within a state-wide collaborative from 2017 to 2018. A minimum of 10 and maximum of 20 responses to a 1-year postoperative questionnaire from each site were randomly sampled. We examined percent agreement between patient-reported and medical chart audit comorbidity assessment and further evaluated agreement by intraclass correlation or κ statistic. Postoperative comorbidities assessed include weight, hyperlipidemia, hypertension, diabetes, depression, obstructive sleep apnea, gastroesophageal reflux disease (GERD), anxiety, and pain.

Results: Five hundred eighty-five patients completed postoperative questionnaires after laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass. The response rate was 64% during the study period. Patients reported weight with a mean difference of 2.7 lbs from chart weight (intraclass correlation = 0.964). Agreement between patient report and audit for all comorbidities was above 80% except for GERD (71%). κ statistics were greater than 0.6 (good agreement) for hyperlipidemia, hypertension, diabetes, and depression. Anxiety ( κ = 0.45) and obstructive sleep apnea ( κ = 0.53) had moderate agreement. Concordance for GERD and pain were fair (both κ = 0.38).

Conclusions: Patient-reported comorbidity assessment has high levels of agreement with medical chart audit for many comorbidities and can improve understanding of long-term outcomes. This will better inform patients and providers with hopes of 1 day moving beyond the 1%.

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Conflict of interest statement

The authors report no conflicts of interest.

References

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