Bariatric surgery in obese patients with heart failure was associated with a reduced rate of HF exacerbation at 13-24 months post-surgery compared to baseline (9.9% vs 16.2%; OR 0.57, p=0.003).
Observational (n=524)
Yes
Does bariatric surgery reduce emergency department visits or hospitalizations for heart failure exacerbation in obese patients with heart failure?
Bariatric surgery is associated with a significant reduction in emergency department visits and hospitalizations for heart failure exacerbation in obese patients with heart failure.
Odds Ratio: 0.57
Absolute Event Rate: 9.9% vs 16.2%
p-value: p=0.003
BACKGROUND: The United States is battling obesity and heart failure (HF) epidemics. Although studies have suggested relationships between obesity and HF morbidity, little is known regarding the effects of substantial weight reduction in obese patients with HF. OBJECTIVES: This study investigated whether bariatric surgery is associated with a decreased rate of HF exacerbation. METHODS: We performed a self-controlled case series study of obese patients with HF who underwent bariatric surgery, using the population-based emergency department (ED) and inpatient sample in California, Florida, and Nebraska. Primary outcome was ED visit or hospitalization for HF exacerbation from 2005 to 2011. We used conditional logistic regression to compare the outcome event rate during sequential 12-month periods, using pre-surgery months 13 to 24 as the reference period. RESULTS: We identified 524 patients with HF who underwent bariatric surgery. During the reference period, 16.2% of patients had an ED visit or hospitalization for HF exacerbation. The rate remained unchanged in the subsequent 12-month pre-surgery period (15.3%; p = 0.67). In the first 12-month period after bariatric surgery, we observed a nonsignificantly reduced rate (12.0%; p = 0.052). However, the rate was significantly lower in the subsequent 13 to 24 months after bariatric surgery (9.9%; adjusted odds ratio: 0.57; p = 0.003). By contrast, there was no significant reduction in the rate of HF exacerbation among obese patients who underwent nonbariatric surgery (i.e., cholecystectomy, hysterectomy). CONCLUSIONS: Our findings indicate that bariatric surgery is associated with a decline in the rate of HF exacerbation requiring ED evaluation or hospitalization among obese patients with HF.
“We found that bariatric surgery -- the most effective way to achieve substantial and sustained weight loss -- was associated with a 40 percent reduction in emergency department visits and hospitalizations for heart failure exacerbation. These findings are important because, while both obesity and heart failure are major public health problems in the U.S., little has been known about whether substantial weight loss would decrease the risk of heart-failure-related adverse events.”
Shimada et al. (Mon,) conducted a observational in Heart failure and obesity (n=524). Bariatric surgery vs. Pre-surgery months 13 to 24 was evaluated on ED visit or hospitalization for HF exacerbation (OR 0.57, p=0.003). Bariatric surgery in obese patients with heart failure was associated with a reduced rate of HF exacerbation at 13-24 months post-surgery compared to baseline (9.9% vs 16.2%; OR 0.57, p=0.003).