Predictors of Postoperative Aftercare Attrition among Gastric Bypass Patients

Poor adherence to post-bariatric surgery aftercare continues to challenge surgical practices. The objective of this study was to identify factors that predict poor aftercare attendance among patients who underwent Roux-en-Y Gastric Bypass (RYGB) surgery. A retrospective medical chart review of patients who underwent RYGB from 2002 to 2011 was conducted. Patients with four visits or more in the first 2 years (>50%) were categorized as "acceptable follow-up" and with ≤50% as "poor follow-up." Demographics, presurgical body mass index (BMI), and comorbidities were compared using multivariate analysis. Out of 2,658 patients, 1,092 (41.1%) had acceptable follow-up. Preoperative factors that predicted acceptable follow-up included female gender (odds ratio [OR] 1.41 [95% confidence interval (CI) 1.15-1.72]), older age (OR 1.03 [95% CI 1.03-1.04]), higher BMI at surgery (OR 1.02 [95% CI 1.01-1.03]), and Hispanic ethnicity (OR 1.40 [95% CI 1.15-1.72]). Conversely, presence of diabetes mellitus (OR 0.58 [95% CI 0.39-0.88]), hypertension (OR 0.53 [95% CI 0.39-0.72]), and obstructive sleep apnea (OR 0.39 [95% CI 0.26-0.57]) predicted less adherence to RYGB aftercare. These findings suggest RYGB patients' age, gender, ethnicity, preoperative BMI, and certain comorbidities should be considered to maximize postoperative aftercare attendance.