Abstract 14387: Impact of Bariatric Surgery on Mortality and Heart Failure Readmissions in Heart Failure With Reduced Ejection Fraction

Abstract

Introduction: Real-world data on the impact of bariatric surgery in patients with acute heart failure with reduced ejection fraction (HFrEF) is limited. Hypothesis: Bariatric surgery in patients with HFrEF is associated with a reduction in mortality and HF readmissions at 1 year. Methods: We identified patients with HFrEF that underwent bariatric surgery by analyzing the nationwide readmission database from September 2015 to December 2018 and using the validated ICD-10 CM codes. Propensity score matching was performed to adjust for the confounders. Kaplan Meier curves were utilized for time to event analysis. Cox proportional hazard regression was used to generate hazard ratios. The primary outcome was all-cause mortality at 1 year. Secondary outcomes were readmission due to HF and any other cause at 1 year. Results: Out of 348668 patients with HFrEF, 1519 underwent bariatric surgery. After propensity match, we identified 1519 patients with bariatric surgery and 1544 patients without bariatric surgery. At 1 year, there was no significant difference in all-cause mortality between both the groups (4.01% vs. 3.14%, HR: 0.62, 95% CI: 0.31-1.26, p=0.19). Moreover, regarding the secondary outcomes, there was no significant difference in HF readmissions (20.92% vs. 22.16%, HR: 1.06, 95% CI: 0.89-1.25, p=0.48) as well as readmission due to any other cause (46.24% vs. 46.78%, HR: 0.97, CI: 0.87-1.09, p=0.97) among both the groups at 1 year. Conclusions: Bariatric surgery in patients with HFrEF did not reduce the mortality, HF readmissions, or readmissions due to any cause at 1 year. We need more data looking at larger sample size, long-term follow-up, and quality of life.