Characterization of anxiety level as a prognostic criterion for evaluating clinical outcomes of sleeve gastrectomy

Abstract

Abstract: studying the impact of the mental health component in patients with obesity on the clinical outcomes of metabolic bariatric intervention is a relevant task of modern medicine that requires further study. To characterize the anxiety level of patients in the long-term period after sleeve gastrectomy and its prognostic value for determining the clinical outcomes of metabolic bariatric intervention. We analyzed the clinical treatment outcomes of 93 patients with obesity who underwent sleeve gastrectomy for the period 2018-2022. The group included 69 (74.19%) women and 24 (25.81%) men. The average age of the subjects was 42.20±11.09 years. The initial BMI of the subjects was 46.23±7.65 kg/m². Obesity staging was performed by calculating BMI (Quetelet, 1832). To characterize the clinical outcome of sleeve gastrectomy, we used the Swiss-Finnish BARIatric metabolic outcome score (SF-BARI Score) with an additional assessment of quality of life using the Moorehead-Ardelt QoL Questionnaire. For anxiety characterization, the GAD-7 (Generalized Anxiety Disorder) questionnaire was used. Differences were considered significant at p<0.05. The total clinical result of sleeve gastrectomy corresponded to very good values – 129.77±28.07 points. In 29 (31.18%) individuals, excellent clinical indicators were established, in 38 (40.86%) examined – very good, in 20 (21.51%) – good, in 6 (6.45%) – satisfactory (5 (5.38%) – poor + 1 (1.07%) – suboptimal). Analyzing the severity of anxiety disorder in the examined, the average total result according to the GAD-7 questionnaire was 6.29±5.43 points and corresponded to a mild level of anxiety. In patients with a higher level of anxiety, established by the GAD-7 questionnaire, significantly worse clinical results of sleeve gastrectomy in the long-term postoperative period were proven, confirmed by the presence of a strong inverse correlation between the indicators (τ=-0.76, p<0.00001). The high prognostic value of patient anxiety indicators regarding the determination of clinical results of sleeve gastrectomy in the long-term period has been proven. In particular, the presence of a minimal level of anxiety in the examined is associated with significantly higher chances of forming excellent treatment results (OR=12.50, CI (3.36-46.51), p=0.000004), while significantly higher chances of forming satisfactory results of sleeve gastrectomy were recorded in patients with a high level of anxiety (OR=140.00, CI (11.85-1654.42), p=0.000002). Thus, the high clinical effectiveness of sleeve gastrectomy in treating patients with obesity and the high prognostic value of anxiety indicators for determining the clinical outcomes of metabolic bariatric intervention have been proven. An integral component of improving the effectiveness of treatment, we consider a comprehensive multidisciplinary approach that includes not only body weight control but also assessment of the psychoemotional state of patients after metabolic bariatric intervention.