Early improvement in patient reported disability after bariatric surgery

Abstract

Background: Bariatric surgery is an effective intervention for managing morbid obesity. Little evidence has been reported regarding objective assessments of patient disability after surgery. The World Health Organization Disability Assessment Score 2.0 is a validated tool for assessing the level of disability after surgery, including assessment of difficulty with activities of daily living, social activities, and overall functioning.

Objective: Evaluate patient disability after bariatric surgery at a tertiary care medical center.

Setting: University hospital, United States.

Methods: An institutional review board-approved prospective cohort study included patients undergoing primary bariatric surgery; patients undergoing a revisional procedure were excluded. Patient-reported disability was assessed using World Health Organization Disability Assessment Score 2.0, administered preoperatively and at 1 and 3 months after surgery. Disability scores (maximum of 48 reflecting extreme disability, minimum of 0) were analyzed for statistically significant trends.

Results: One hundred ten patients enrolled in the study (76% female, 24% male) with 46% sleeve gastrectomy and 54% Roux-en-Y gastric bypass. Preoperative body mass index was 47.08 ± 7.6 (n = 110). The preoperative World Health Organization Disability Assessment Score scores were 6.66 ± 6.10 (n = 110). For those who completed both preoperative and 1-month surveys (n = 53), the scores were 6.60 ± 5.76 and 4.04 ± 4.68, respectively (P < .001). Those completing both preoperative and 3-month surveys (n = 53) had scores of 6.08 ± 5.48 and 2.38 ± 3.74, respectively (P < .001).

Conclusion: We report early improvement in disability with a validated tool at 1 and 3 months after bariatric surgery. This equates to global disability in this cohort improving from the 75th percentile of the population norm preoperatively to the 50th percentile at 3 months. Further studies are needed to determine if this is sustained long-term.

Keywords: Bariatric surgery; Disability improvement; Enhanced recovery after surgery; WHODAS.