Impact of bariatric surgery on heart failure mortality

Abstract

BackgroundThe impact of bariatric surgery on discrete cardiovascular events has not been well characterized. ObjectivesTo assess the impact of prior bariatric surgery on mortality associated with heart failure (HF) admission. SettingA retrospective analysis of 2007–2014 Healthcare Cost and Utilization Project—Nationwide Inpatient Sample. MethodsParticipants 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). ResultsWith 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). ConclusionsOur data suggest that prior bariatric surgery is associated with almost 50% reduction in in-hospital mortality and shorter LOS in patients with HF admission.