5-OR: Prior Bariatric Surgery and Perioperative Cardiovascular Outcomes following Noncardiac Surgery in Patients with Type 2 Diabetes Mellitus

Abstract

Background: Diabetes mellitus is a risk factor for perioperative major adverse events. This study aims to evaluate the association between prior bariatric surgery (prior-BS) and perioperative cardiovascular outcomes following noncardiac surgery in patients with type 2 diabetes mellitus (T2DM). Methods: We used the National Inpatient Database to identify major noncardiac surgery in T2DM patients from 2006 to 2014. The primary outcome is major perioperative adverse cardiovascular and cerebrovascular events (MACCE), which included death, acute myocardial infarction and acute ischemic stroke. In-hospital outcomes between patients with prior-BS and morbid obesity were compared using unadjusted logistic, multivariable logistic and propensity score matching analyses. Results: A weighted of 152,6820 patients diagnosed with T2DM who underwent noncardiac surgery were included. Both rates of prior-BS and morbid obesity significantly increased during the study period (P<0.0001). Patients with prior-BS were younger, more likely to be female and had more smoking, alcohol abuse, anemia and prior venous thromboembolism and prior percutaneous coronary intervention. Incidence of MACCE was 1.01% and 3.25% in patients with prior-BS and morbid obesity, respectively. After multivariable adjustment, we found that prior-BS was associated with reduced risk of MACCE (odds ratio[OR]: 0.71; 95% confidence interval [CL]: 0.62-0.81), death (OR: 0.64; 95%CI: 0.52-0.78), acute kidney injury (OR: 0.66; 95%CI: 0.62-0.70) and acute respiratory failure (OR: 0.46; 95%CI: 0.42-0.50). Conclusions: Prior bariatric surgery in diabetes mellitus patients who underwent noncardiac surgery is associated with lower risk of MACCE. Prospective studies are need to verify the benefits of bariatric surgery in noncardiac surgery. Disclosure J. Jin: None. H. Li: None. P. Zhang: None. Y. Li: None. Funding China Postdoctoral Science Foundation (2018M640871)