Preoperative Mental Disorders and Hospital Healthcare Use in the First Year After Metabolic Bariatric Surgery: A Retrospective Study

TL;DR

This study found that patients with mental disorders before weight-loss surgery had higher healthcare use in the first year after the procedure.

Contribution

The study is novel in linking preoperative mental disorders to increased postoperative healthcare utilization after metabolic bariatric surgery.

Findings

Patients with preoperative mental disorders had a 15% higher rate of total healthcare use in the first postoperative year.

Those with mental disorders had a 61% higher rate of gastrointestinal-related healthcare use.

Mental disorders were weakly associated with healthcare use, with models explaining only 5–13% of the variation.

Abstract

Mental disorders are relatively common in individuals who undergo metabolic bariatric surgery (MBS). Prior research suggests that mental disorders may relate to increased healthcare use after MBS. We retrospectively explored the association between preoperative mental health disorders and healthcare use in the first postoperative year.

Patients who underwent primary MBS and had a structured preoperative psychological assessment report were included. Data on healthcare use was collected as the total number of non-routine healthcare appointments including inpatient, outpatient, and emergency department visits. Additionally, gastrointestinal (GI) healthcare use at the radiology, gastroenterology, and emergency departments was analyzed separately.

Of the 944 included patients, 261 (28%) had a preoperatively diagnosed mental disorder. Most prevalent were depressive disorders, anxiety disorders, and eating disorders. Patients with a preoperative mental disorder had a 15% (adjusted, CI 1.04–1.27, p = 0.005) higher rate of total healthcare use compared to those without. Among patients who had any GI-related healthcare, those with a mental disorder had a 61% higher rate of GI-related healthcare use (CI 1.02–2.55, p = 0.041). Patients with a mental disorder tended to have 20% lower odds of having no GI-related healthcare appointments (unadjusted, not statistically significant, CI 0.37–1.74, p = 0.568).

The presence of preoperative mental disorders was weakly related to higher total non-routine hospital healthcare use in the first year after MBS. Models explained only 5–13% of the variation in appointment frequency, meaning unmeasured and/or unknown factors play a role in healthcare use.

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