Oral Presentation ANZOS Annual Scientific Meeting 2021

Comorbidity and outcomes following bariatric surgery in a public hospital multidisciplinary intensive weight loss program (#72)

Annette Macdonald 1 , Caroline Cusack 1 , Sarah Driscoll 1 2 , Michael Edye 1 2 3 , Brendan Ryan 1 3 , Michael Devadas 1 3 , Benjamin Woodham 1 3 , Amy Phu 4 , Jesmine Yap 1 , Meera Kamdar 1 , Dean Spirou 1 , Golo Ahlenstiel 2 4 5 , Ramy H Bishay 1 2
  1. Metabolic & Weight Loss Program, Department of Endocrinology and Diabetes, Blacktown Hospital, Blacktown, NSW, Australia
  2. School of Medicine, University of Western Sydney, Sydney, NSW, Australia
  3. Department of Surgery, Blacktown Hospital, Blacktown, NSW, Australia
  4. Storr Liver Centre, Westmead Millennium Institute, Westmead Hospital, University of Sydney, Sydney, NSW, Australia
  5. Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, NSW, Australia

BACKGROUND The majority of bariatric surgeries in Australia are performed in private hospitals (93.8%) compared to public settings (6.2%). Publicly funded operations are generally provided to patients who have completed an intensive lifestyle and education program prior to bariatric surgery, though outcomes is less known in this setting. METHODS A prospective analysis of comorbidity and clinical data on all patients who have completed the 1-year intensive lifestyle program and have had bariatric surgery at the Blacktown Metabolic & Weight Loss Program between 2017 to 2021. Patients were referred by the primary care physician from the Western Sydney community and required a BMI>35 kg/m2 plus type 2 diabetes or BMI>40 kg/m2 plus 2 obesity complications to be enrolled in the program. RESULTS 72 patients were included in the analysis. Mean age was 48.5±10.2yrs, weight 144±31kg, BMI 51±11kg/m2, waist circumference 143.0±26.8 cm, with females comprising 68%. Mean systolic (SBP) and diastolic blood pressures (DBP) were 134.6±16.9mmHg and 81.6 ±11mmHg, respectively, with mean glycosylated haemoglobin A1c of 7.4±1.9%. Patients were primarily of Edmonton Obesity Stage II (41%) or III (41%). Prevalence of comorbidities was very high, with baseline rates of fatty liver disease of 93%, chronic kidney disease 78%, hypertension 74%, type 2 diabetes 71% (of whom 29% required insulin), obstructive sleep apnoea 57%, depression 49%, joint disease 49%, thyroid disease 19%, PCOS 18%, and cardiovascular disease 15%. In line with national trends, 62% of the cohort had a laparoscopic sleeve gastrectomy, with 38% receiving a single anastomosis gastric bypass. To date, mean excess weight loss 1-year following surgery (n=23) was 48.6±23.9%, with significant reductions in SBP (-13 mmHg) and DBP (-6.3 mmHg). Data collection is ongoing. CONCLUSION Outcomes of publicly funded bariatric programs is comparative to other settings and is imperative to improve patient care and access to this underfunded resource.