SF-BARI Score for Assessment of Long-Term Results in Patients with BMI ≥ 50 kg/m2 Submitted to Roux-en-Y Gastric Bypass or Sleeve Gastrectomy

Abstract

Background: Patients with a body mass index (BMI) ≥ 50 kg/m2 present significant challenges in terms of treatment options, and data on long-term outcomes following metabolic and bariatric surgery (MBS) in this population remain limited. This study aims to explore the long-term outcomes of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in patients with BMI ≥ 50 kg/m2, utilizing the Swiss-Finnish Bariatric Metabolic Outcome Score (SF-BARI Score)—a comprehensive tool that incorporates multiple outcome dimensions—and to identify factors that may influence these outcomes. Methods: Retrospective cohort study of patients with BMI ≥ 50 kg/m2 submitted to RYGB or SG between January 2010 and September 2021, with more than 5 years of follow-up. Several data were collected, and the SF-BARI score was calculated and analyzed. Statistical analysis was performed to identify variables that influenced the score. Results: We identified 89 patients with long-term follow-up (mean 96.6 months, SD 18.9) after RYGB or SG. The mean SF-BARI score was 94.2 (SD 29.5), with most patients’ outcomes categorized as good. Seventy-six (85.4%) patients had %TWL ≥ 20, but only 34.8% of patients had a final BMI < 35 kg/m2. Statistical analysis revealed that younger patients have higher SF-BARI scores related to comorbidities improvement. Conclusion: Our findings suggest that both RYGB and SG lead to satisfactory long-term outcomes for treatment of patients with BMI ≥ 50 kg/m2, according to the SF-BARI score. However, only one-third achieved a BMI < 35 kg/m2. Younger patients seem to achieve better results, particularly in comorbidity improvements. MBS outcomes should be reported in a standardized manner, addressing key components such as weight loss, improvement in comorbidities, complications, and quality of life.