Predictors for Adherence to Multidisciplinary Follow-Up Care after Sleeve Gastrectomy

A considerable proportion of patients who undergo bariatric surgeries (BS) do not attend routine postoperative follow-up despite recommendations for such. Data are sparse regarding the various aspects of patient adherence to consultations following sleeve gastrectomy (SG).

To examine predictors of adherence to SG follow-up, reasons for attrition from follow-up, and the relationship between adherence to follow-up and weight loss results.

A retrospective cohort study was performed with a mean follow-up of 3 years. Data were collected from electronic medical records and telephone questionnaires. Adherence was defined both as a numerical variable (ranking 0-9 according to the number of pre-scheduled postoperative visits) and as a dichotomous variable (adherent and non-adherent groups).

Of 178 patients, 46.63% were defined as "adherent," according to the dichotomous definition. Compared to the "non-adherent group," patients in the "adherent group" more regularly used vitamin D after the surgery, had fewer rehospitalizations, and reported a lower intake of sweetened beverages. The main reasons for attrition were work-related and difficulties in mobility. Adherence to postoperative follow-up was not found to be correlated to weight loss. Older age (OR = 1.04; p = 0.026) and postoperative side effects (OR = 2.33; p = 0.035) were found to be positive predictors for adherence, whereas rehospitalizations (OR = 0.08; p = 0.028) and ethnical minority status were negative predictors (OR = 0.42; p = 0.019).

Adherence to postoperative follow-up was found to be associated with positive lifestyle behaviors; however, no correlation was found to mid-term weight loss outcomes.