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. 2022 Nov;32(11):3571-3580.
doi: 10.1007/s11695-022-06216-4. Epub 2022 Jul 27.

Comprehensive Analysis of Improvements in Health-Related Quality of Life and Establishment of QALY Gains in a Government-Funded Bariatric Surgical Program with 5-Year Follow-up

Chiara Chadwick  1   2 , Paul R Burton  3   4 , Jennifer Reilly  3   5 , Julie Playfair  3 , Cheryl Laurie  3 , Kalai Shaw  3   4 , Wendy A Brown  3   4
Affiliations

Comprehensive Analysis of Improvements in Health-Related Quality of Life and Establishment of QALY Gains in a Government-Funded Bariatric Surgical Program with 5-Year Follow-up

Chiara Chadwick et al. Obes Surg. 2022 Nov.

Abstract

Purpose: Bariatric surgery is an efficacious intervention for substantial and sustained weight reduction in individuals with morbid obesity resulting in health improvements. However, the changes to a patient's health related quality of life (HRQoL) in the medium to longer term after bariatric surgery have not been adequately characterized. Our aim was to evaluate the change to patient HRQoL 5 years following bariatric surgery in an Australian government-funded hospital system and determine the significance of relationships between change in physical and mental assessment scores and HRQoL utility scores.

Materials and methods: We performed a longitudinal panel study of 81 adult patients who underwent primary bariatric surgery at an Australian tertiary government-funded hospital and completed multi-attribute utility (MAU), multi-attribute non-utility (MA), and disease-specific adjusted quality of life (AQoL) questionnaires before and after bariatric surgery.

Results: At a mean (SD) 5.72 (1.07) years postbariatric surgery, participants demonstrated statistically significant improvements in mean AQoL-8D utility (0.135 (0.21); P < 0.0001), yielding a mean 3.2 (1.67) QALYs gained. Beck Depression Inventory-II scores improved (baseline mean 17.35 (9.57); 5-year mean 14.7 (11.57); P = 0.037). Short Form-36 scores improved in the domains of physical functioning and role limitations due to physical health and general health. Change in depression scores and patient satisfaction with surgery were found to be significant predictors of follow up AQoL utility scores.

Conclusions: Bariatric surgery improves physical and psychological quality of life measures over 5 years. The improvement of patient QALYs provide insight to the potential cost utility of publicly funded bariatric surgery in the medium term.

Keywords: Bariatric surgery; HRQoL; QALY; Quality of life.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of baseline and follow-up mean AQoL-8D weighted utility scores. ****P < 0.001, ***P < 0.005, **P < 0.01, *P < 0.05
Fig. 2
Fig. 2
Baseline vs follow-up mean RAND SF-36 domain scores. ****P < 0.001, ***P < 0.005, **P < 0.01, *P < 0.05
Fig. 3
Fig. 3
Change in depression severity index scores and severity
Fig. 4
Fig. 4
Change in mean Dakkak dysphagia severity (****P < 0.001)
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