Quality-of-life assessment of morbidly obese patients who have undergone aLap-Band (R) operation: 2-year follow-up study - Is the MOS SF-36 a usefulinstrument to measure quality of life in morbidly obese patients?

Background: Quality of life (QoL) was tested in a 2-year postoperative stud y using the Medical Outcome Study Short Form 36 (MOS SF-36) to assess preop erative and 1 and 2 year postoperative QoL among one group of female patien ts (group 1, n = 42) and a 2 year postoperative QoL study il 1 a second gro up of female patients (group 2, n = 9) who underwent a stomach reduction op eration involving open surgical placement of a Lap-Band during the year 199 7. Methods: The QoL of 42 patients (group 1) was assessed at most 20 hours bef ore surgery and 1 and 2 years (12 and 24 months) postoperatively using a ra ndomized pre-test/post-test design. The QoL of 9 patients (group 2) was ass essed :2 years (24 months) postoperatively using a randomized post-test des ign only. The results were compared with the standardized Dutch norm datasc ale. Statistical data were analyzed with SPSS versions 10.0. Results: The placement of a Lap-Band in group 1 resulted in a significant r eduction in Body Mass Index (BMI) in the first and second-year follow-up. M ean BMI declined significantly from 40.7 kg/m(2) preoperatively to 33.1 kg/ m(2) at the 1-year follow-up, to 31.3 kg/m(2) at 2-year follow-up. In group 2 BMI also declined significantly from 43.0 kg/m(2) preoperatively to 34.2 kg/m(2) at 1-year follow-up to 32.1 kg/m(2) at the 2-year follow-up. Compa red to the MOS SF-36 standardized Dutch norm data, a significant improvemen t in the QoL was seen on the effect variable bodily pain, mental health and general health perceptions in group 1. Although the bodily pain, general h ealth and mental health perceptions increased significantly 2 years postope ratively (group 1) compared with the Dutch standardized norm data, the preo perative general health and mental health perceptions of morbidly obese pat ients were, like all other preoperative effect variables, not significantly different from the scores on the Dutch standardized norm scale. Conclusion: Although other authors found that QoL improves after surgical-i nduced weight loss, showing significant improvements on patients' perceptio n of their health status, these findings were not confirmed in the present study. The findings show only a significant difference in bodily pain, gene ral health and mental health perception before and after surgical intervent ion and preoperatively in group 1 compared to the Dutch standardized norm d ata. Because of small sample size (n = 9), no significant results were foun d in group 2 compared to the Dutch Standardized norm data. Based on earlier and present findings, further study is recommended to ascertain whether th e MOS SF-36 is valid in morbidly obese patients and whether the response se t has an influence on QoL studies of these patients.