Metabolic Syndrome Is a Significant Predictor of Postoperative Morbidity and Mortality Following Bariatric Surgery

Lak, Kathleen; Helm, Melissa C.; Kindel, Tammy L.; Gould, Jon C.

doi:10.1007/s11605-018-4035-z

Cited by 15 publications

(16 citation statements)

References 14 publications

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“…In an NSQIP study of bariatric surgery performed between 2012 and 2014, Lak and colleagues reported that patients with MetS were more likely to have Roux-en-Y gastric bypass procedures, and these patients have an increased risk for morbidity and mortality after bariatric surgery compared with patients without MetS. 15 In a study comparing the effectiveness of LSG versus LRYGB for obese patients with MetS, Du et al 11 found that the remission rate of MetS was similar between the two groups (74.7% for LSG vs 82.5% for LRYGB); however, LSG appears to be inferior with regard to control of hypertension and improvement of high-density lipoprotein cholesterol. In a study comparing patients who underwent LSG (n = 107) versus LRYGB (n = 159) for remission of MetS within a VA setting, Nassour et al 16 found that the remission rate was similar between the two groups (37.6% for LRYGB vs 26.8% for LSG) at four years and LRYGB was associated with a greater rate of morbidity.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Sleeve Gastrectomy or Laparoscopic Gastric Bypass for Patients with Metabolic Syndrome: An MBSAQIP Analysis

Alizadeh

Gambhir

et al. 2019

The American Surgeon

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In patients undergoing bariatric surgery, the presence of metabolic syndrome (MetS) contributes to perioperative morbidity. We aimed to evaluate the utilization and outcome of severely obese patients with MetS who underwent laparoscopic sleeve gastrectomy (LSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB). Using the 2015 and 2016 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, data were obtained for patients with MetS undergoing LSG or LRYGB. There were 29,588 MetS patients (LSG: 58.7% vs LRYGB: 41.3%). There was no significant difference in 30-day mortality (0.1% for LSG vs 0.2% for LRYGB, adjusted odds ratio (AOR) 0.58, confidence interval (CI) 0.32–1.05, P = 0.07) or length of stay between groups (2 ± 2 for LSG vs 2.2 ± 2 days for LRYGB, P = 0.40). Compared with LRYGB, LSG was associated with significantly shorter operative time (78 ± 39 vs 122 ± 54 minutes, P < 0.01), lower overall morbidity (2.3% vs 4.4%, AOR 0.53, CI 0.46–0.60, P < 0.01), lower serious morbidity (1.5% vs 2.3%, AOR 0.64, CI 0.53–0.76, P < 0.01), lower 30-day reoperation (1.2% vs 2.3%, AOR 0.52, CI 0.43–0.63, P < 0.01), and lower 30-day readmission (4.2% vs 6.6%, AOR 0.62, CI 0.55–0.69, P < 0.01). In conclusion, LSG is the predominant operation being performed for severely obese patients with MetS, and its popularity may in part be related to its improved perioperative safety profile.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Sleeve Gastrectomy or Laparoscopic Gastric Bypass for Patients with Metabolic Syndrome: An MBSAQIP Analysis

Alizadeh

Gambhir

et al. 2019

The American Surgeon

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“…Metabolic syndrome is a clustering of cardiovascular risk factors: obesity, increased blood pressure, increased blood glucose, increased triglycerides, and lowered HDL. It is associated with increased risk of mortality [23,24], as well as type 2 diabetes mellitus [24][25][26], cancer [27,28], surgical complications [29,30], dementia [31,32], and heart failure [33]. Although metabolic syndrome is not considered a disease, research into its prevention is crucial for human health.…”

Section: Introductionmentioning

confidence: 99%

Risk of Developing Metabolic Syndrome Is Affected by Length of Daily Siesta: Results from a Prospective Cohort Study

et al. 2021

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Background: Siesta has been associated with increased incidence of cardiovascular disease but the mechanism remains unclear. New studies into the relationship between siesta and metabolic syndrome have identified siesta length as a crucial differential, suggesting that siesta less than 40 min is associated with decreased risk of metabolic syndrome, while longer siesta is associated with increased risk. We aimed to investigate the effect of siesta duration on development of metabolic syndrome in a Mediterranean population using a prospective cohort study design. Methods: Our sample consisted of 9161 participants of the SUN cohort without components of metabolic syndrome at baseline. Siesta exposure was assessed at baseline and the development of metabolic syndrome components was assessed after an average 6.8 years of follow-up. We estimated odds ratios and fitted logistic regression models to adjust for potential cofounders including night-time sleep duration and quality, as well as other diet, health, and lifestyle factors. Results: We observed a positive association between average daily siesta >30 min and development of metabolic syndrome (aOR = 1.39 CI: 1.03–1.88). We found no significant difference in risk of developing metabolic syndrome between the group averaging ≤30 min of daily siesta and the group not taking siesta (aOR = 1.07 CI: 0.83–1.37). Further analysis suggested that average daily siesta <15 min may reduce risk of metabolic syndrome. Conclusions: Our study supports the J-curve model of the association between siesta and risk of metabolic syndrome, but suggests the protective effect is limited to a shorter range of siesta length than previously proposed.

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“…15 MetS has previously been shown to negatively impact outcomes in numerous other surgical undertakings, but its association with thyroidectomy remains unknown. [16][17][18][19][20] Although complex, MetS is a lifestyle-dependent illness that has shown to be reversible even on a short-term time scale with vigorous exercise and dieting. [21][22][23] Because the thyroid and MetS share a metabolic relation, thyroidectomies are elective, and MetS is at times a factor under patient control, we believed determining the impact MetS may have on thyroidectomy outcomes to be crucial.…”

Section: Introductionmentioning

confidence: 99%

“…A third of all adults in the United States are believed to have metabolic syndrome and this rate continues to rise 15 . MetS has previously been shown to negatively impact outcomes in numerous other surgical undertakings, but its association with thyroidectomy remains unknown 16‐20 . Although complex, MetS is a lifestyle‐dependent illness that has shown to be reversible even on a short‐term time scale with vigorous exercise and dieting 21‐23 …”

Section: Introductionmentioning

confidence: 99%

Evaluating the impact of metabolic syndrome on postoperative thyroidectomy outcomes

et al. 2020

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Objective: Metabolic syndrome (MetS) has previously been linked to increased risk of postoperative morbidity and mortality in other surgical undertakings. Because MetS is a consequence of endocrine dysfunction, and given the thyroid's crucial role in endocrine homeostasis, we sought to evaluate the association between MetS and postoperative outcomes of thyroidectomy. Methods: Data were acquired from the ACS-NSQIP database from years 2005 to 2017. Patients with obesity, diabetes, and hypertension were defined as having MetS. Odds ratios (OR) were obtained for outcomes to quantify risk with multivariate logistic regression. Results: Outcomes significantly affected by MetS included overall complication (OR: 2.00), extended postoperative stay (OR: 1.52), medical complication (OR: 1.48), surgical complication (OR: 1.62), and mortality (OR: 2.33). Conclusions: Patients with MetS undergoing thyroidectomy are at increased risk of an increased length of stay, overall complications, and mortality.

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Metabolic Syndrome Is a Significant Predictor of Postoperative Morbidity and Mortality Following Bariatric Surgery

Cited by 15 publications

References 14 publications

Laparoscopic Sleeve Gastrectomy or Laparoscopic Gastric Bypass for Patients with Metabolic Syndrome: An MBSAQIP Analysis

Laparoscopic Sleeve Gastrectomy or Laparoscopic Gastric Bypass for Patients with Metabolic Syndrome: An MBSAQIP Analysis

Risk of Developing Metabolic Syndrome Is Affected by Length of Daily Siesta: Results from a Prospective Cohort Study

Evaluating the impact of metabolic syndrome on postoperative thyroidectomy outcomes

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