Preoperative risk factors for suboptimal initial clinical response or weight regain in patients undergoing bariatric surgery, a retrospective cohort study from a high-volume center

INTRODUCTION: Bariatric surgery is widely recognized as a mainstay in the treatment of obesity; however, there is limited information regarding its success and the factors that influence outcomes within the Mexican population. This study provides an analysis of bariatric surgery outcomes at the "Hospital de Especialidades" of the "Centro Médico Nacional Siglo XXI," with a particular focus on the prevalence of suboptimal initial clinical response, weight regain, and the identification of predictive factors. METHODS: A retrospective cohort study involving 132 patients who underwent bariatric surgery between January 2018 and March 2023 was conducted. The prevalence of suboptimal initial clinical response was determined, and a binary logistic regression was applied to identify potential risk factors. RESULTS: The study found that 21.97% of patients experienced suboptimal initial clinical response, a rate lower than reported in global literature. The population exhibited a significant prevalence of comorbidities, including type 2 diabetes mellitus (63.64%), hypertension (55.3%), and obstructive sleep apnea (60.61%), reflecting Mexico's high obesity rates. Additionally, male sex was identified as a significant predictor of suboptimal initial clinical response, while glycated hemoglobin and serum albumin emerged as relevant biochemical predictors, underscoring the importance of preoperative glycemic control. CONCLUSION: These findings offer valuable insights into bariatric surgery outcomes and identifies adequate preoperative glycemic control as an important modifiable factor that can inform future policies aimed at enhancing patient care and surgical success in bariatric procedures.