Use of the MMPI-2 personality profile in predicting 30-day ED-visits and readmissions following primary bariatric surgery

Abstract

Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is used for psychological screening of bariatric surgery (BS) candidates. To date, no studies have analyzed the relationship between MMPI-2 and early returns to hospital. The aim of this study was to determine whether high T scores on the MMPI-2 clinical scales were associated with early return to hospital after primary bariatric surgery. Patients who completed an MMPI-2 evaluation, undergoing primary BS from 2014 to 2016 were evaluated. T score for the tested scales were collected and stratified into a high T score (T>65) vs not (T<65). The optimal 'cut-point' (specific number of high T scores predicting likelihood for 30-day ED-visit/hospital readmission) was calculated using Youden's Index (J)=Max(c) [sensitivity (c)+specificity (c)-1], where c=number of scales with a T score>65. Patients were stratified based on the optimal cut-point which was determined to be≥4 high T scores. Univariate and multivariate logistic regression analyses were used to identify differences between groups and predictors for early ED-visits and hospital readmissions. 375 patients had psychological evaluations available for review. Patients were divided into those with≥4 high T scores (Scr(≥4); n=86) versus not (Scr (<4); n=289). Multivariate analysis showed Scr(≥ 4) (aOR 2.99, CI 1.20-7.47; p=0.019), bipolar disorder (aOR 4.82, CI 1.25-18.83; p=0.022), and urgent hospital complications (aOR6.81, CI 2.02-22.91; p=0.002), were significant independent predictors of 30-day readmissions. Early ED-visits were significantly predicted by public insurance (aOR 3.30, CI 1.22-8.91; p=0.019), but the effect of the Scr(≥4) profile (aOR 2.42, CI 0.97-6.09; p=0.06), while influential, did not reach significance. Differences in personality traits may be associated increased 30-day readmissions following primary bariatric surgery. Our study represents a novel application of the MMPI-2.