To determine the accuracy of post-operative patient-reported comorbidity assessment, as it may be an important mechanism for long-term follow-up in surgical patients.
Summary Background Data:
Less than 1% of patients who qualify actually undergo bariatric surgery which may be due to concerns surrounding long-term efficacy. Longitudinal follow-up of patients’ comorbidities remains a challenge.
Retrospective, cross-sectional study of bariatric surgery patients from 38 sites within a state-wide collaborative from 2017–2018. A minimum of 10 and maximum of 20 responses to a 1-year postoperative questionnaire from each site were randomly sampled. We examined percent agreement between patient-reported and medical chart audit comorbidity assessment and further evaluated agreement by ICC or κ statistic. Post-operative comorbidities assessed include weight, hyperlipidemia, hypertension, diabetes, depression, obstructive sleep apnea, GERD, anxiety, and pain.
585 patients completed post-operative questionnaires after laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass. The response rate was 64% during the study period. Patients reported weight with a mean difference of 2.7lbs from chart weight (ICC = 0.964). Agreement between patient report and audit for all comorbidities was above 80% except for GERD (71%). κ statistics were greater than 0.6 (good agreement) for hyperlipidemia, hypertension, diabetes, and depression. Anxiety (κ=0.45) and OSA (κ=0.53) had moderate agreement. Concordance for GERD and pain were fair (both κ=0.38).
Patient-reported comorbidity assessment has high levels of agreement with medical chart audit for many comorbidities and can improve understanding of long-term outcomes. This will better inform patients and providers with hopes of one day moving beyond the 1%.