Key result
Higher socioeconomic status and postoperative weight loss were strongly associated with greater improvements in health-related quality-of-life 2 years after laparoscopic gastric bypass surgery (unadjusted B 16.3 for weight loss).
Why the study?
Patients with low socioeconomic status often experience poorer surgical outcomes, but the influence of socioeconomic factors on health-related quality-of-life after bariatric surgery remains unclear.
Do socioeconomic factors influence the improvement in health-related quality-of-life after laparoscopic gastric bypass surgery in patients with obesity?
Cohort (n=13,723)
Yes
Do socioeconomic factors influence the improvement in health-related quality-of-life after laparoscopic gastric bypass surgery in patients with obesity?
Effect estimate: unadjusted B 16.3 (95% CI 14.72-17.93)
p-value: p=<0.0001
Socioeconomic factors, including education, income, and heritage, significantly influence the degree of improvement in health-related quality-of-life two years after laparoscopic gastric bypass surgery.
Lower SES linked to smaller HRQoL gains after gastric bypass; leaves open whether targeted support improves outcomes in disadvantaged patients.
INTRODUCTION: Patients with low socioeconomic status have been reported to experience poorer outcome after several types of surgery. The influence of socioeconomic factors on health-related quality-of-life (HRQoL) after bariatric surgery is unclear. MATERIALS AND METHODS: Patients operated with a primary laparoscopic gastric bypass procedure in Sweden between 2007 and 2015 were identified in the Scandinavian Obesity Surgery Register. Patients with a completed assessment of health-related quality-of-life based on the Obesity-related Problem Scale (OP Scale) were included in the study. Socioeconomic status was based on data from Statistics Sweden. RESULTS: A total of 13,723 patients (32% of the 43,096 operated during the same period), with complete OP scores at baseline and two years after surgery, were included in the study. Age, lower preoperative BMI, male gender, higher education, professional status and disposable income as well as not receiving social benefits (not including retirement pension), and not a first- or second-generation immigrant, were associated with a higher postoperative HRQoL. Patients aged 30-60 years, with lower BMI, higher socioeconomic status, women and those born in Sweden by Swedish parents experienced a higher degree of improvement in HRQoL. Postoperative weight-loss was associated with higher HRQoL (unadjusted B 16.3, 95%CI 14.72-17.93, p < 0.0001). CONCLUSION: At 2 years, a strong association between weight loss and improvement in HRQoL was seen, though several factors influenced the degree of improvement. Age, sex, preoperative BMI and socioeconomic status all influence the postoperative HRQoL as well as the improvement in HRQoL after laparoscopic gastric bypass surgery.
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Gryth et al. (2019) conducted a cohort in Severe obesity (n=13,723). Socioeconomic factors and weight loss vs. Lower socioeconomic status / less weight loss was evaluated on Improvement in health-related quality-of-life, estimated with the Obesity-related Problem Scale (OP Scale) at 2 years (unadjusted B 16.3, 95% CI 14.72-17.93, p=<0.0001). Higher socioeconomic status and postoperative weight loss were strongly associated with greater improvements in health-related quality-of-life 2 years after laparoscopic gastric bypass surgery (unadjusted B 16.3 for weight loss).
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