Application of BAROS’ questionnaire in obese patients undergoing bariatric surgery with 2 years of evolution

QUEIROZ, Caetano de; SALLET, José Afonso; DE BARROS E SILVA, Pedro Gabriel Melo; QUEIROZ, Luzia da Gloria Pereira de Sousa; PIMENTEL, Jélis Arenas; SALLET, Paulo Clemente

doi:10.1590/S0004-2803.2017v54n1-12

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ORIGINAL ARTICLE • Arq. Gastroenterol. 54 (01) • Jan-Mar 2017 • https://doi.org/10.1590/S0004-2803.2017v54n1-12 copy

Application of BAROS’ questionnaire in obese patients undergoing bariatric surgery with 2 years of evolution

Aplicação do questionário BAROS em pacientes obesos submetidos à cirurgia bariátrica com 2 anos de evolução

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND

-In recent decades, the high prevalence of obesity in the general population has brought serious concerns in terms of public health. Contrarily to conventional treatment involving dieting and physical exercising, often ineffective in generating long term results, bariatric operations have been an effective method for sustained weight loss in morbidly obese individuals. The Bariatric Analysis and Reporting Outcome System (BAROS) is an objective and recognized system in the overall evaluation of results after bariatric surgery.

OBJECTIVE

To investigate results concerning a casuistic of morbidly obese patients undergoing bariatric surgery over a 2-year follow-up in terms of weight loss, related medical conditions, safety and changes in quality of life.

METHODS

A total of 120 obese (17 male and 103 female) patients, who underwent bariatric surgery, were assessed and investigated using the BAROS system after a 2- year follow-up.

RESULTS

Patients obtained a mean excess weight loss of 74.6 (±15.9) % and mean body mass index reduction of 15.6 (±4.4) Kg/m². Pre-surgical comorbidities were present in 71 (59%) subjects and they were totally (86%) or partially (14%) resolved. Complications resulting specifically from the surgical procedure were observed in 4.2% of cases (two bowel obstructions requiring re-operation, and three stomal stenosis treated with endoscopic dilation). Sixteen subjects (13% of total number of patients) presented minor clinical complications managed through outpatient care. The final scores for the BAROS questionnaire showcased excellent to good results in 99% of cases (excellent 44%, very good 38%, good 23%, acceptable 1%).

CONCLUSION

According to the BAROS questionnaire, bariatric surgery is a safe and effective method for managing obesity and associated clinical comorbidities, allowing for satisfactory results after a 2-year follow-up. Future studies should address other clinical and psychosocial variables that impact outcome as well as allow for longer follow-ups.

Headings:
Morbid obesity; Bariatric surgery; Body weight; Quality of life

Gender	Age	Baseline	Baseline	Excess	Final Weight	Final BMI	BMI	%Excess	Hospital
	(years)	BMI	Weight	Weight			Reduction	Weight Loss	(days)
Male (n=17)	36.2 (±7.6)	46.1 (±6.4)	152.3 (±32.7)	81.5 (±31.0)	101.4 (±21.4)	32.2 (±5.9)	13.9 (±5.9)	63.4 (±15.5)	3.4 (±1.0)
Female (n=103)	36.2 (±7.0)	44.2 (±4.3)	120.5 (±16.2)	61.2 (±14.0)	74.7 (±12.5)	28.3 (±4.3)	15.8 (±4.1)	76.5 (±15.3)	3.4 (±1.8)
Total (n=120)	36.2 (±7.1)	44.5 (±4.7)	125.0 (±22.2)	64.0 (±18.7)	78.5 (±16.8)	28.9 (±4.8)	15.6 (±4.4)	74.6 (±15.9)	3.4 (±1.7)
Statistics	F=0.001;	F=2.48;	F=39.6;	F=20.01;	F=52.93;	F=10.19;	F=2.71	F=10.68
Men:Women	P=0.970	P=0.118	P<0.001	P<0.001	P<0.001	P=0.002	P=0.102	P=0.001
Statistics					T=39.7;	T=38.4;
BaseLine:Final					df=119;	df=119;
					P<0.000	P<0.000

Gender	BAROS %EWL	BAROS QoL	BAROS Control	BAROS	Total BAROS
			Comorbidities	Complications
Men (n=17)	2.12 (±0.70)	2.08 (±0.75)	1.24 (±1.39)	-0.13 (±0.33)	5.3 (±1.5)
Women (n=103)	2.52 (±0.57)	2.36 (±0.68)	1.77 (±1.44)	-0.13 (±0.30)	6.6 (±1.7)
Total (n=120)	2.47 (±0.61)	2.32 (±0.69)	1.69 (±1.44)	-0.13 (±0.30)	6.4 (±1.7)
Mann-Whitney U test	Mann-Whitney	Mann-Whitney	Mann-Whitney	Mann-Whitney	Mann-Whitney
	(P=0.018)	(P=0.140)	(P=0.110)	(P=0.586)	(P=0.005)

	Complications	N (%)
SURGICAL
Major (-1.0)
Early	Bowel obstruction (*)	2 (1.7%)
Late	---	---
Minor (-0.2)
Early	---	---
Late	Stomal stenosis	3 (2.5%)
CLINICAL
Major (-1.0)
Early	Pulmonary embolism	1 (0.8%)
Late	---	---
Minor (-0.2)
Early	Deep venous thrombosis	2 (1.7%)
	Dysfagia	1 (0.8%)
	Urinary tract infection	1 (0.8%)
	Persistent nausea and vomiting	1 (0.8%)
Late	Anemia	7 (5.8%)
	Renal lithiasis	1 (0.8%)
	Metabolic deficiency	2 (1.7%)
	Depression	1 (0.8%)
Incidental
Cholelithiasis*
(-1.0)
Late	After bariatric surgery	9 (7.5%)
	(2 year- follow up)

Total BAROS Categorical data	Acceptable	Good	Very good	Excellent
Man	0	9	3	5
(n=17)		(7.5%)	(2.5%)	(4.2%)
Women	1	19	35	48
(n=103)	(0.8%)	(15.8%)	(29.2%)	(40%)
Total	1	28	38	53
(n=120)	(0.8%)	(23.3%)	(31.7%)	(44.2%)

Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. Rua Dr. Seng, 320, 01331-020 São Paulo - SP Brasil, Tel./Fax: +55 11 3147-6227 - São Paulo - SP - Brazil
E-mail: secretariaarqgastr@hospitaligesp.com.br

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[1] Correspondence: Jélis Arenas Pimentel. Rua Gomes de Carvalho, 1507. Bairro Vila Olímpia - CEP: 04547-005 - São Paulo, SP, Brasil. E-mail: jelisarenas@gmail.com