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Purpose <p>To identify clinical and sociodemographic factors that predict follow-up discontinuation and rehospitalisation after multidisciplinary residential rehabilitation for severe obesity, thereby defining high-risk patient profiles and guiding tailored retention strategies.</p> Methods <p>We retrospectively followed 1,851 adults with obesity discharged from a multidisciplinary residential programme between 2015 and 2018 (median BMI 42&#xa0;kg m⁻²). Dropout, defined as more than twelve months without contact, was studied with discrete-time survival models; time to rehospitalisation was analysed with Cox regression.</p> Results <p>Within twelve months 1,513 patients (87%) discontinued follow-up. Each five-year increase in age lowered drop-out risk (HR 0.97, 95% CI 0.94–0.99, <i>p</i> = 0.004); diabetes had a similar protective effect (HR 0.89, 0.79–1.00, <i>p</i> = 0.0455). Rehospitalisation occurred in 591 patients (32%). Risk increased with age (5-years increment; HR = 1.05, 95% CI 1.01–1.09, <i>p</i> = 0.0191), baseline BMI (HR = 1.04, 95% CI 1.03–1.05, <i>p</i> &lt; 0.0001), diabetes (HR = 1.22, 95% CI 1.02–1.30, <i>p</i> = 0.0306) and eating disorders (HR = 1.48, 95% CI 1.07–2.05, <i>p</i> = 0.0193).</p> Discussion <p>Maintaining the benefits of residential rehabilitation is important. In our cohort, 87% of patients dropped out of follow-up within one year and 32% were readmitted. Two distinct profiles emerged: younger and non-diabetic subjects were prone to dropout, while patients with higher BMI, diabetes, or eating disorders were at higher risk of rehospitalization. Early identification of these groups may suggest flexible, technology-assisted follow-up for working-age patients and integrated metabolic-psychiatric care for complex cases, safeguarding outcomes and optimizing resources.</p>

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Hazard and determinants of dropout and rehospitalization in patients with obesity after residential rehabilitation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月27日

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  • Daniele Sola,
  • Samuele Minari,
  • Raffaella Sabatino,
  • Davide Soranna,
  • Elisa Prina,
  • Stefania Mai,
  • Silvia Martinelli,
  • Roberta Vietti,
  • Raffaella Radin,
  • Alessandra Rimella,
  • Antonella Zambon,
  • Massimo Scacchi

摘要

Purpose

To identify clinical and sociodemographic factors that predict follow-up discontinuation and rehospitalisation after multidisciplinary residential rehabilitation for severe obesity, thereby defining high-risk patient profiles and guiding tailored retention strategies.

Methods

We retrospectively followed 1,851 adults with obesity discharged from a multidisciplinary residential programme between 2015 and 2018 (median BMI 42 kg m⁻²). Dropout, defined as more than twelve months without contact, was studied with discrete-time survival models; time to rehospitalisation was analysed with Cox regression.

Results

Within twelve months 1,513 patients (87%) discontinued follow-up. Each five-year increase in age lowered drop-out risk (HR 0.97, 95% CI 0.94–0.99, p = 0.004); diabetes had a similar protective effect (HR 0.89, 0.79–1.00, p = 0.0455). Rehospitalisation occurred in 591 patients (32%). Risk increased with age (5-years increment; HR = 1.05, 95% CI 1.01–1.09, p = 0.0191), baseline BMI (HR = 1.04, 95% CI 1.03–1.05, p < 0.0001), diabetes (HR = 1.22, 95% CI 1.02–1.30, p = 0.0306) and eating disorders (HR = 1.48, 95% CI 1.07–2.05, p = 0.0193).

Discussion

Maintaining the benefits of residential rehabilitation is important. In our cohort, 87% of patients dropped out of follow-up within one year and 32% were readmitted. Two distinct profiles emerged: younger and non-diabetic subjects were prone to dropout, while patients with higher BMI, diabetes, or eating disorders were at higher risk of rehospitalization. Early identification of these groups may suggest flexible, technology-assisted follow-up for working-age patients and integrated metabolic-psychiatric care for complex cases, safeguarding outcomes and optimizing resources.