Loss to follow-up after laparoscopic gastric bypass surgery – a post hoc analysis of a randomized clinical trial.

Follow-up after bariatric surgery is important if we are to identify long-term complications at an early stage and thereby improve long-term outcome. Despite great efforts, many patients are lost to follow-up. Definition of characteristics of patients failing to attend follow-up could help in defining a specific group for whom extra resources may be applied to improve the situation. To identify characteristics of patients failing to attend follow-up 2 years after laparoscopic gastric bypass surgery. Multicenter study, Sweden. Post hoc analysis of a randomized clinical trial in which preoperative patient characteristics and postoperative outcome measures were compared between patients who attended or did not attend a 2-year follow-up visit after laparoscopic gastric bypass surgery. Of the 2495 patients included, 260 did not attend a 2-year follow-up visit. Factors associated with higher risk for failure to attend were younger age (adjusted odds ratio [OR].96, 95% confidence interval [CI].94–.98/yr, P <.001); male sex (adjusted OR 2.34, 95% CI 1.51–3.63, P <.001); depression (adjusted OR 1.61, 95% CI 1.05–2.47, P =.029); history of smoking (adjusted OR 1.78, 95% CI 1.26–2.51, P =.001); being single (adjusted OR 1.47, 95% CI 1.03–2.11, P =.036); and being first-generation immigrant (adjusted OR 1.74, 95% CI 1.05–2.88; P =.032). Elementary occupation (adjusted OR.42, 95% CI.18–.99, P =.047) was associated with lower risk. These findings indicate that there are preoperative characteristics that may help in identifying patients likely to fail to attend follow-up visits after laparoscopic gastric bypass surgery. Special effort should be made to inform these patients of the importance of follow-up and to encourage them to attend. Younger age, male gender, depression, ethnicity, marital status and smoking all influence the risk not to attend 2-year follow-up visit. Preoperative characteristics can be used to identify patients at risk for failure to attend follow-up visits after gastric bypass surgery [ABSTRACT FROM AUTHOR]