Elsevier

Surgery for Obesity and Related Diseases

Volume 1, Issue 1, January–February 2005, Pages 17-21
Surgery for Obesity and Related Diseases

Original articles
Travel distance, age, and sex as factors in follow-up visit compliance in the post-gastric bypass population

https://doi.org/10.1016/j.soard.2004.11.001Get rights and content

Abstract

Background

There is no consensus regarding the optimal rate of follow-up in the post-bariatric surgery patient population.

Methods

The records of all patients who underwent laparoscopic Roux-en-Y gastric bypass from 2001 to 2003 were reviewed. Using patient zip codes, travel distances were calculated between the patients’ places of residence and our clinic. Patients were then assigned to 1 of 3 cohorts according to the following distances: (1) < 50 miles, (2) 50 to 100 miles, and (3) > 100 miles. Patient compliance with follow-up appointments at 3 weeks, 3 months, 6 months, 9 months, and 12 months was analyzed. Linear trends were identified using the Mantel-Haenszel test. Age and sex were analyzed as possible predictors of compliance using the χ2 test. P values < .05 were considered statistically significant.

Results

The study group comprised 150 patients (127 females and 23 males). The 3 cohorts contained 115, 21, and 14 patients, respectively. All patients in each cohort were compliant with the 3-week follow-up appointment. Although there were differences in compliance between cohorts at each of the remaining appointments, only the 9-month (70.3% vs 61.9% vs 35.7%) visit showed statistical significance (P = .035). The 6-month visit trended toward significance (85.2% vs 76.2% vs 64.3%; P = .088). Males were more likely to be compliant with the 12-month follow-up (P = .040). When controlling for sex, travel distance was also a predictor of compliance at this follow-up visit (P = .024). Age was not predictive of compliance (P = .827).

Conclusion

Based on our findings, we conclude that travel distance from the clinic does not significantly affect compliance at the initial follow-up, 3-month, and 12-month appointments. However, distance does tend to affect compliance at the 6-month appointment and significantly affects compliance at the 9-month appointment. Males are more likely to be compliant at the 12 month follow-up visit. We must continue to strive for 100% follow-up in our post-bariatric surgery patients.

Section snippets

Methods

In this study, data from all consecutive patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) at Gundersen Lutheran Medical Center (GLMC) during the period September 2001 to April 2003 were prospectively entered into an electronic database. All surgeries were performed by a single surgeon (SNK). The patients’ follow-up data was cross-referenced using their home zip codes. Travel distance from their place of residence to our clinic was determined using this information. Patients

Results

Of the 150 patients in the study group, 127 were female and 23 were male. The average age was 41.6 years, and the average body mass index (BMI) was 49.2. All patients were followed through the 12-month postoperative period. There were a total of 115 patients in the < 50 miles group, 21 patients in the 50 to 100 miles group, and 14 patients in the > 100 miles group. Figure 1 shows the number of patients from each group who were compliant with each follow-up appointment. Attrition began to be

Discussion

GLMC is a 350-physician, multispecialty group located in the western Wisconsin city of La Crosse. It serves an area covered by 19 counties across 3 states: Wisconsin, southeastern Minnesota, and northeastern Iowa. A community-based, 325-bed teaching hospital, GLMC has an accredited general surgery program that graduates 2 chief residents per year and a fellow in advanced laparoscopy with an emphasis in bariatric surgery.

Figure 3 depicts the tri-state region. The star represents La Crosse,

Conclusion

Many factors play a role in patient compliance with postoperative follow-up visits after gastric bypass surgery. Travel distance appears to be a significant factor at the 9-month appointment, but not at the 3-, 6-, and 12-month appointments. However, when controlling for sex, shorter travel distance is predictive of better compliance at the 12-month visit. Age does not appear to be a factor. The optimal schedule of follow-up visits in the post-gastric bypass population remains to be determined.

References (2)

  • American Society for Bariatric Surgery. Guidelines for granting privileges in bariatric surgery: Global credentialing...
  • R. Shen et al.

    Impact of patient follow-up on weight loss after bariatric surgery

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    (2004)

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Supported by the R. James Trane Surgical Research and Data Center of the Gundersen Lutheran Medical Foundation, and the United States Surgical Corporation.

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