<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0212-1611</journal-id>
<journal-title><![CDATA[Nutrición Hospitalaria]]></journal-title>
<abbrev-journal-title><![CDATA[Nutr. Hosp.]]></abbrev-journal-title>
<issn>0212-1611</issn>
<publisher>
<publisher-name><![CDATA[Grupo Arán]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0212-16112025000400695</article-id>
<article-id pub-id-type="doi">10.20960/nh.05886</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Predictores del fracaso terapéutico a largo plazo tras la cirugía bariátrica: modelo de regresión logística basado en parámetros nutricionales y metabólicos]]></article-title>
<article-title xml:lang="en"><![CDATA[Predictors of long-term therapeutic failure after bariatric surgery: a logistic regression model based on nutritional and metabolic parameters]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[Ángel Martínez]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Nunes]]></surname>
<given-names><![CDATA[Manuella González]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Amador]]></surname>
<given-names><![CDATA[Francisco Javier Fraile]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Piñeiro]]></surname>
<given-names><![CDATA[Noelia Pena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ulloa]]></surname>
<given-names><![CDATA[Maite Argibay]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Patiño]]></surname>
<given-names><![CDATA[Raquel Ruades]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Servicio de Endocrinología y Nutrición Servicio de Endocrinología y Nutrición ]]></institution>
<addr-line><![CDATA[Pontevedra ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Unidad de Enfermería Unidad de Enfermería ]]></institution>
<addr-line><![CDATA[Pontevedra ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Universitario Montecelo Servicio de Medicina Interna ]]></institution>
<addr-line><![CDATA[Pontevedra ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2025</year>
</pub-date>
<volume>42</volume>
<numero>4</numero>
<fpage>695</fpage>
<lpage>701</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0212-16112025000400695&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0212-16112025000400695&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0212-16112025000400695&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo: este estudio analizó la evolución del fracaso terapéutico tras la cirugía bariátrica y validó un modelo predictivo de riesgo a 10 años. Se buscó integrar variables clínicas y resultados posquirúrgicos para identificar factores asociados al fracaso y establecer un umbral clínicamente útil para el seguimiento.  Métodos: se realizó un estudio observacional de cohortes retrospectivas en 96 pacientes (78,1 % de mujeres, edad media de 41,3 años, IMC: 44,6 kg/m²) sometidos a bypass gástrico (n = 75) o gastrectomía vertical (n = 19). El fracaso terapéutico se definió como una pérdida &lt; 50 % del exceso de peso o la recidiva de comorbilidades. Se desarrolló un modelo de regresión logística con IMC inicial, %PEP al año, pérdida de IMC, DM2 y HTA. Se validó mediante curvas ROC y prueba de Hosmer-Lemeshow.  Resultados: el fracaso aumentó del 18 % al 32 % en 10 años. Factores de riesgo: IMC elevado (OR = 1,24), DM2 (OR = 3,77) y HTA (OR = 3,83). La pérdida de IMC al año fue protectora (OR = 0,72). El modelo mostró una buena capacidad predictiva (AUC = 0,858), con umbral óptimo en 28,6 % (sensibilidad del 84,6 %, especificidad del 80,6 %, VPN del 93,1 %). El bypass tuvo una menor tasa de fracaso (28 % vs. 38 %) y un mejor rendimiento predictivo (AUC = 0,89 vs. 0,78).  Conclusiones: el modelo predice adecuadamente el fracaso a largo plazo y el bypass gástrico resulta más efectivo, recomendándose su priorización en los pacientes con mayor IMC o comorbilidades.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective: this study analyzed long-term therapeutic failure after bariatric surgery and validated a 10-year predictive risk model. We aimed to integrate clinical and postoperative variables to identify failure-associated factors and establish a clinically useful threshold for follow-up.  Methods: a retrospective observational cohort study was conducted including 96 patients (78.1% women, mean age 41.3 years, BMI 44.6 kg/m²) who underwent gastric bypass (n = 75) or sleeve gastrectomy (n = 19). Therapeutic failure was defined as &lt; 50 % excess weight loss or recurrence of comorbidities. A logistic regression model was developed including baseline BMI, %EWL at 1 year, BMI reduction, type 2 diabetes (T2DM), and hypertension (HTN). Model performance was assessed using ROC curves and the Hosmer-Lemeshow test.  Results: failure rates increased from 18 % to 32 % over 10 years. Risk factors: higher baseline BMI (OR = 1.24), T2DM (OR = 3.77), and HTN (OR = 3.83). One-year BMI loss was protective (OR = 0.72). The model showed strong predictive capacity (AU C = 0.858), with an optimal threshold of 28.6 % (sensitivity 84.6 %, specificity 80.6 %, NPV 93.1 %). Gastric bypass had lower failure rates (28 % vs. 38 %) and better predictive performance (AUC = 0.89 vs. 0.78).  Conclusions: the model effectively predicts long-term failure, with gastric bypass demonstrating superior outcomes. We recommend prioritizing this procedure for patients with higher BMI or comorbidities.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cirugía bariátrica]]></kwd>
<kwd lng="es"><![CDATA[Predicción clínica]]></kwd>
<kwd lng="es"><![CDATA[Obesidad severa]]></kwd>
<kwd lng="es"><![CDATA[Comorbilidades]]></kwd>
<kwd lng="es"><![CDATA[Seguimiento a largo plazo]]></kwd>
<kwd lng="en"><![CDATA[Peso corporal]]></kwd>
<kwd lng="en"><![CDATA[Bariatric surgery]]></kwd>
<kwd lng="en"><![CDATA[Clinical prediction]]></kwd>
<kwd lng="en"><![CDATA[Severe obesity]]></kwd>
<kwd lng="en"><![CDATA[Comorbidities]]></kwd>
<kwd lng="en"><![CDATA[Long-term follow-up]]></kwd>
<kwd lng="en"><![CDATA[Body weight]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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