Impact of bariatric surgery on heart failure mortality. Surg Obes Relat Dis 2019 Jul;15(7):1189-1196
Date
05/31/2019Pubmed ID
31147281DOI
10.1016/j.soard.2019.03.021Scopus ID
2-s2.0-85066108211 (requires institutional sign-in at Scopus site) 26 CitationsAbstract
BACKGROUND: The impact of bariatric surgery on discrete cardiovascular events has not been well characterized.
OBJECTIVES: To assess the impact of prior bariatric surgery on mortality associated with heart failure (HF) admission.
SETTING: A retrospective analysis of 2007-2014 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample.
METHODS: Participants including 2810 patients with a principal discharge diagnosis of HF who also had a history of prior bariatric surgery were identified. These patients were matched 1:5 with patients who had similar principal diagnoses but no history of bariatric surgery (controls). Propensity scores, balanced on baseline characteristics, were used to assemble 2 control groups. Control group-1 included patients with obesity (body mass index [BMI] ≥35 kg/m2) only. In control group-2, the BMI was considered as one of the matching criteria in propensity matching. Multivariate regression models were utilized to calculate the odds ratio (OR) and 95% confidence interval (CI) of mortality and length of stay (LOS).
RESULTS: With well-balanced matching, 33,720 (weighted) patients were included in the analysis. In-hospital mortality rates after HF admission were significantly lower in patients with a history of bariatric surgery compared with control group-1 (0.96% versus 1.86%, OR .52, 95% CI .35-0.77, P = .0013) and control group-2 (0.96% versus 1.86%, OR .52, 95% CI .35-0.77, P = .0011). Furthermore, LOS was shorter in the bariatric surgery group compared with control group-1 (4.8 ± 4.4 versus 5.7 ± 5.7 d, P < .001) and control group-2 (4.8 ± 4.4 versus 5.4 ± 6.3 d, P < .001).
CONCLUSIONS: Our data suggest that prior bariatric surgery is associated with almost 50% reduction in in-hospital mortality and shorter LOS in patients with HF admission.
Author List
Aleassa EM, Khorgami Z, Kindel TL, Tu C, Tang WHW, Schauer PR, Brethauer SA, Aminian AAuthor
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultBariatric Surgery
Female
Heart Failure
Hospital Mortality
Hospitalization
Humans
Male
Middle Aged
Obesity, Morbid
Postoperative Complications
Retrospective Studies