27.1% of sleeve gastrectomy and 33.0% of gastric bypass patients had preoperative depression.
Patients with preoperative depression experienced slightly less weight loss after gastric bypass compared to those without depression.
No significant difference in weight loss was observed for sleeve gastrectomy patients based on depression status.
Improvements in blood sugar levels () were slightly greater for depressed patients after gastric bypass.
Depression status did not influence diabetes remission or relapse rates, nor did it affect reoperations, revisions, or mortality across both surgical procedures.
Depression was associated with an increased risk of needing endoscopy and repeat hospitalizations after gastric bypass compared to sleeve gastrectomy.
Simplified
OBJECTIVE: To examine whether depression status before (MBS) influenced 5-year weight loss, diabetes, and safety/utilization outcomes in the PCORnet Bariatric Study.
SUMMARY OF BACKGROUND DATA: Research on the impact of depression on MBS outcomes is inconsistent with few large, long-term studies.
METHODS: Data were extracted from 23 health systems on 36,871 patients who underwent sleeve gastrectomy (SG; n=16,158) or gastric bypass (RYGB; n=20,713) from 2005-2015. Patients with and without a depression diagnosis in the year before MBS were evaluated for % total weight loss (%TWL), diabetes outcomes, and postsurgical safety/utilization (reoperations, revisions, endoscopy, hospitalizations, mortality) at 1, 3, and 5 years after MBS.
RESULTS: 27.1% of SG and 33.0% of RYGB patients had preoperative depression, and they had more medical and psychiatric comorbidities than those without depression. At 5 years of follow-up, those with depression, versus those without depression, had slightly less %TWL after RYGB, but not after SG (between group difference = 0.42%TWL, P = 0.04). However, patients with depression had slightly larger improvements after RYGB but not after SG (between group difference = - 0.19, P = 0.04). Baseline depression did not moderate diabetes remission or relapse, reoperations, revision, or mortality across operations; however, baseline depression did moderate the risk of endoscopy and repeat hospitalization across RYGB versus SG.
CONCLUSIONS: Patients with depression undergoing RYGB and SG had similar weight loss, diabetes, and safety/utilization outcomes to those without depression. The effects of depression were clinically small compared to the choice of operation.
Key numbers
27.1% of SG patients
Patients with Depression
Percentage of sleeve gastrectomy patients diagnosed with depression preoperatively.
0.42%TWL
Weight Loss Difference
Difference in % total weight loss after RYGB between patients with and without depression at 5 years.
-0.19
Improvement
Change in levels for patients with depression after RYGB compared to those without.
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