Improvement in patient-reported outcomes in Chinese adults after bariatric surgery: 1-year follow-up of a prospective cohort

Abstract

Objective: To assess changes of patient-reported outcomes in terms of health-related quality of life (HRQOL), depression, anxiety status and physical activity (PA) after bariatric surgery among patients with obesity. Settings: Queen Mary Hospital, Tung Wah Hospital and United Christian Hospital, Hong Kong SAR; a longitudinal study. Methods: A multi-center prospective observational cohort was conducted in Hong Kong between 2017 and 2018. Follow-up interviews at 1-month, 3-month, 6-month and 12-month postoperatively were administrated via telephone. Short Form-12 Health Survey Version 2 (SF-12v2), Euroqol 5-dimension-5-level (EQ-5D-5L) and Impact of Weight on Quality of Life-Lite (IWQOL-Lite) were utilized to assess HRQOL. Scores of anxiety and depression were evaluated by Hospital Anxiety and Depression Scale (HADS). Walking, moderate and vigorous metabolic equivalent tasks (MET) and PA levels were measured by International Physical Activity Questionnaire-Short Form (IPAQ-SF). Demographic and clinical characteristics including age, gender, body mass index and pre-existing comorbidities at baseline were collected. Comparisons of scores were made between baseline and 12 months using paired t-test or McNemar test. Results: A total of 25 patients who have received bariatric surgery (Laparoscopic sleeve gastrectomy: 96%; laparoscopic gastric bypass: 4%) and 25 control patients matched using propensity scores derived by baseline covariates were involved. Significant improvements were observed in HRQOL regarding physical functioning (P<0.001), role physical (P=0.013), bodily pain (P=0.011), general health (P<0.011), vitality (P=0.029), social functioning (P=0.017), and physical composite summary (P<0.001) of SF-12v2 from baseline to follow-up 12 months after surgery. Scores of physical composite summary, mental composite summary and SF-6D of surgical patients all had an overall upward trend during observation when compared with those in the control group. All domains in IWQOL-Lite were significantly higher at 12 months when compared with baseline (P=0.001 in sexual life domain, P<0.001 in other domains). Patients experienced a decrease in depression score of HADS 12 months after bariatric surgery (P=0.026), while anxiety score was not found to differ from baseline (P=0.164). No significant differences in total MET (P=0.224) and PA levels (P=0.180) between baseline to 12-month follow-up were found. Conclusion: After 12 months of follow-up, increase in physical quality of life, reduction in depression status and less impairment caused by weight were observed, without significant changes in anxiety score and postoperative PA.