Background

Pre-operative psychiatric clearance (PC) by a mental health professional for patients undergoing Bariatric Surgery (BS) is important for successful postoperative outcomes. This study aims to determine the relationship between the level of psychiatric fitness and post-operative outcomes in patients undergoing BS.

Methods

This retrospective study includes patients who underwent BS at Ascension Borgess Hospital between 2010 and 2019. Patients were categorized based upon level of PC using a 0-3 scale (PC0=failed initial assessment/eventually passed, PC1=”fair”, PC2=”good”, PC3=”strong”). Primary outcome was percent of Excess Weight Loss (EWL) and secondary outcome was missed postoperative visits and number of compliance issues. Differences between groups were analyzed using Kruskal-Wallis and Wilcoxon rank-sum tests.

Results

We report the results of preliminary analysis. Of 885 patients, 705 (79.7%) were females. Comparing the three groups who passed initial psychiatric evaluation (PC1, PC2, PC3), no difference was noted in EWL (53.0% vs. 49.6% vs. 47.8%, p=0.35). Additionally, no difference was seen when patients missed ≥4 postop visits (28.8% vs. 24.7% vs. 30.2%, p=0.10), or had ≥3 compliance issues (41.1% vs. 39.7% vs. 38.6%, p=0.71). When comparing the group of patients with PC0 to the group with PC1-3, no difference in EWL was observed (37.9% vs. 49.7%, p=0.06).

Conclusions

Preliminary results show no significant difference in the postoperative outcomes of bariatric patients based on level of psychiatric clearance. Additionally, no difference was seen in EWL between those who received 0 designation (PC0) and other groups (PC1-3). Once completed, data will be re-analyzed to further determine existing relationships.