Early Outcomes of Bariatric Surgery in Patients with Metabolic Syndrome: An Analysis of the Bariatric Outcomes Longitudinal Database

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• 作者：William B. Inabnet III ; MD ; FACS^a ; ^{william.inabnet@mountsinai.org} ; Deborah A. Winegar ; PhD^b ; Bintu Sherif ; MS^b ; Michael G. Sarr ; MD ; FACS^c
• 关键词：ASMBS ; American Society for Metabolic and Bariatric Surgery ; BMI ; body mass index ; BOLD ; Bariatric Outcomes Longitudinal Database ; BPD/DS ; biliopancreatic diversion with duodenal switch ; BSCOE ; Bariatric Surgery Centers of Excellence ; MetS ; metabolic synd
• 刊名：Journal of the American College of Surgeons
• 出版年：2012
• 期刊代码：175_10727515
• 类别：med
• 出版时间：April, 2012
• 卷：214
• 期：4
• 页码：550-556
• 文件大小：214 K

摘要

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Background

Metabolic syndrome (MetS) complicating obesity is endemic in the United States.

Study Design

Bariatric Outcomes Longitudinal Database, the national database for the American Society for Metabolic and Bariatric Surgery Bariatric Surgery Center of Excellence Program, was queried to identify patients undergoing bariatric surgery from June 2007 through November 2010. MetS was defined as the presence of hypertension, diabetes, and dyslipidemia at presentation for bariatric surgery. Ninety-day and 1-year outcomes were assessed to determine early outcomes in bariatric surgery patients with MetS.

Results

Among 186,576 research-consented patients, 23,106 (12%) were diagnosed with MetS. Patients with MetS were more likely to be male (35%vs 20%; p < 0.0001), older (mean age 54 vs 44 years; p < 0.0001), and Caucasian (81%vs 74%; p < 0.0001). Of the 23,106 MetS patients, more underwent gastric bypass (RYGB) (62%) compared with gastric banding (32%), sleeve gastrectomy (4.5%), and biliopancreactic diversion with duodenal switch (BPD/DS)(1.5%). MetS patients had an increase in serious complications (2.4%vs 1.0%; p < 0.0001), readmissions (6.2%vs 4.7%; p < 0.0001), and mortality (0.3%vs 0.1%; p < 0.0001) within 90 days of operation. After adjusting for sex, age, and body mass index, RYGB patients with MetS had an increased risk of 90-day serious complications compared to RYGB patients without MetS (odds ratio 1.43; 95%CI, 1.27 to 1.61; p < 0.0001). The 12-month remission rate of diabetes was least for gastric banding (28%) compared with the other procedures (RYGB 62%, sleeve gastrectomy 52%, BPD/DS 74%).

Conclusions

Patients with MetS undergoing bariatric surgery showed dramatic improvement in diabetes 1-year after surgery; however, an adverse 90-day outcome was more common.