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

Abstract

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.

The Evaluation of Serum Endocan, Interleukin-6, and CRP Levels Following Sleeve Gastrectomy

“…Although the previous studies presented substantial short and long-term survival benefits of BS, the short and long-term mortality predictors in obese individuals remain lacking and objective of debate. 34 , 35 Whether some inflammation markers may be predictors of mortality in this regard needs clarification in the future. In this study, we have presented evidence of an association between serum endocan, IL-6, and CRP and obesity and BS.…”

Prediction of Early and Long-Term Hospital Readmission in Patients with Severe Obesity: A Retrospective Cohort Study

“…Patients with obesity are at increased risk of hospitalization compared to the general population [ 17 , 18 , 19 , 20 ]. This fact points out the fragility of this patient cohort, and represents a relevant healthcare issue for several reasons; from the patient’s perspective, hospitalization can be a disruptive and stressful experience, with a significant impact on their mental and physical well-being, independence, and social support network [ 47 , 48 ]; from the healthcare perspective, repeated hospitalizations are related to higher healthcare costs [ 19 , 21 , 22 , 23 ]. Moreover, unplanned hospital readmission has been proposed as a performance indicator of health care quality [ 49 , 50 ], although this point is up for debate.…”

“…Patients with obesity consume more healthcare resources compared with normal-weight individuals [ 12 , 13 , 14 , 15 , 16 ]. A remarkable part of these costs is determined by hospitalizations and inpatient care; indeed, adults with obesity are at increased risk of hospitalization compared to the general population [ 17 , 18 , 19 , 20 ], with high hospitalization-related healthcare costs [ 19 , 21 , 22 , 23 ].…”