Bariatric Surgery and Hospitalization for Heart Failure in Morbidly Obese Patients

Sidhu, Gursukhmandeep; Samson, Rohan; Ayinapudi, Karnika; Jemtel, Thierry H. Le

doi:10.1007/s11695-020-04787-8

Cited by 9 publications

(2 citation statements)

References 59 publications

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“…Similarly, a systematic review and meta-analysis of observational studies demonstrated improved LVEF and reduced rates of HF exacerbations leading to hospital admission after bariatric surgery in patients with obesity. 43 Sidhu et al 44 also demonstrated that patients with obesity who had undergone bariatric surgery had significantly lower in-hospital mortality and length of stay when hospitalized for HF compared to patients who had not had bariatric surgery. Although pooling of changes in LVEF was not possible in this systematic review due to limited reporting, several included studies reported improvements in LVEF following bariatric surgery in patients with reduced EF.…”

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery as a Bridge to Heart Transplantation in Morbidly Obese Patients

Lee

Anvari

Soon

et al. 2020

Cardiology in Review

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Class 2 obesity or greater [body mass index (BMI) >35 kg/m 2 ] is a relative contraindication for heart transplant due to its associated perioperative risks and mortality. Whether bariatric surgery can act as a potential bridging procedure to heart transplantation is unknown. The aim of this systematic review and meta-analysis is to investigate the role of bariatric surgery on improving transplant candidacy in patients with end-stage heart failure (ESHF). MEDLINE, EMBASE, CENTRAL, and PubMed databases were searched up to September 2019 for studies that performed bariatric surgery on patients with severe obesity and ESHF. Outcomes of interest included incidence of patients listed for heart transplantation after bariatric surgery, proportion of patients that successfully received transplant, the change in BMI after bariatric surgery, and 30-day complications. Pooled estimates were calculated using a random-effects meta-analysis of proportions. Eleven studies with 98 patients were included. Mean preoperative BMI was 44.9 (2.1) kg/m 2 and BMI after surgery was 33.2 (2.3) kg/m 2 with an absolute BMI reduction of 26.1%. After bariatric surgery, 71% [95% confidence interval (CI), 55-86%] of patients with ESHF were listed for transplantation. The mean time from bariatric surgery to receiving a heart transplant was 14.9 (4.0) months. Of the listed patients, 57% (95% CI, 39-74%) successfully received heart transplant. The rate of 30-day mortality after bariatric surgery was 0%, and the 30-day major and minor complications after bariatric surgery was 28% (95% CI, 10-49%). Bariatric surgery can facilitate sustained weight loss in obese patients with ESHF, improving heart transplant candidacy and the incidence of transplantation.

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Section: Discussionmentioning

confidence: 99%

Bariatric Surgery as a Bridge to Heart Transplantation in Morbidly Obese Patients

Lee

Anvari

Soon

et al. 2020

Cardiology in Review

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“…However, older studies included other surgical procedures and/or open techniques, which are more invasive and associated with a higher proportion of surgery-related complications and hospital use [ 13 , 24 , 28 ]. Indeed, recent cohort studies found a shorter length of stay and overall better hospitalization outcomes after BS [ 43 , 44 ]. In-hospital admissions of our BS cohort, although less frequent and shorter in duration, were more complex, as documented by the increase in the DRG’s weight.…”

Section: Discussionmentioning

confidence: 99%

Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

et al. 2021

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Bariatric surgery (BS) confers a survival benefit in specific subsets of patients with severe obesity; otherwise, effects on hospital admissions are still uncertain. We assessed the long-term effect on mortality and on hospitalization of BS in patients with severe obesity. This was a retrospective cohort study, including all patients residing in Piedmont (age 18–60 years, BMI ³ 40 kg/m2) admitted during 2002–2018 to the Istituto Auxologico Italiano. Adjusted hazard ratios (HR) for BS were estimated for mortality and hospitalization, considering surgery as a time-varying variable. Out of 2285 patients, 331 (14.5%) underwent BS; 64.4% received sleeve gastrectomy (SG), 18.7% Roux-en-Y gastric bypass (RYGB), and 16.9% adjustable gastric banding (AGB). After 10-year follow-up, 10 (3%) and 233 (12%) patients from BS and non-BS groups died, respectively (HR = 0.52; 95%CI 0.27–0.98, by a multivariable Cox proportional-hazards regression model). In patients undergoing SG or RYGB, the hospitalization probability decreased significantly in the after-BS group (HR = 0.77; 0.68–0.88 and HR = 0.78; 0.63–0.98, respectively) compared to non-BS group. When comparing hospitalization risk in the BS group only, a marked reduction after surgery was found for all BS types. In conclusion, BS significantly reduced the risk of all-cause mortality and hospitalization after 10-year follow-up.

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Evidence of Bariatric Surgery Benefits Cardiac Function in Non-HFpEF Patients with Obesity: a Meta-Analysis

Lu,

Zhang,

Zhang

et al. 2023

OBES SURG

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Bariatric Surgery and Hospitalization for Heart Failure in Morbidly Obese Patients

Cited by 9 publications

References 59 publications

Bariatric Surgery as a Bridge to Heart Transplantation in Morbidly Obese Patients

Bariatric Surgery as a Bridge to Heart Transplantation in Morbidly Obese Patients

Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

Evidence of Bariatric Surgery Benefits Cardiac Function in Non-HFpEF Patients with Obesity: a Meta-Analysis

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