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ASSOCIATION OF COMPLIANCE WITH POSTOPERATIVE FOLLOW UP AND WEIGHT LOSS OUTCOMES FOLLOWING SLEEVE GASTRECTOMY
Matthew Romine^*, Katey Feng, Britney Corey, Richard Stahl, Jayleen Grams
Surgery, University of Alabama-Birmingham, Birmingham, AL
Introduction: Compliance with recommended postoperative follow up is poor among patients undergoing bariatric surgery. The purpose of this study was to evaluate the association of follow up compliance and weight loss outcomes after laparoscopic sleeve gastrectomy.

Methods: A retrospective review of all adult patients undergoing laparoscopic sleeve gastrectomy at a single academic institution from 2011 to 2017 was performed. Patients were stratified into high and low compliance groups: high compliance was defined as attendance at 4-8 versus low compliance at attendance at 0-3 out of 8 total possible postoperative visits. Univariate and multivariate analyses were used to compare patient characteristics and weight loss outcomes. Percent weight loss over time was calculated using a mixed-effects multivariate linear regression model. Statistical significance was determined as p<0.05.

Results: A total of 217 patients were stratified into high compliance (n=49) and low compliance (n=168) groups. Of the 217 patients, 179 (82.5%) patients were female and 121 (55.5%) were European American. There were no statistically significant differences in preoperative demographics, weight, BMI, or rates of diabetes, hypertension, obstructive sleep apnea, or hyperlipidemia between the two groups. In adjusted analysis, the high compliance group had a statistically significant greater percent weight loss at 1 year vs the low compliance group (28.3% vs 24.5%, respectively; p=0.031). On linear regression modeling comparing the groups using data from all bariatric visits, there was no significant difference in percent weight loss (p=0.138).

Conclusions: The majority of patients undergoing laparoscopic sleeve gastrectomy had low compliance with recommended postoperative bariatric visits. Low compliance with postoperative follow up was associated with poorer weight loss outcomes at 1 year. Further studies with a larger sample size and longer term follow up are needed.

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