Bariatric surgery outcomes in morbidly obese with the metabolic syndrome at US academic centers.
ABSTRACT The metabolic syndrome is associated with significant cardiovascular morbidity and mortality. We assessed the in-hospital outcomes of bariatric surgery in morbidly obese patients with the metabolic syndrome in comparison to a control group without the metabolic syndrome.
Using ICD-9-CM diagnosis and procedure codes, clinical data for 20,242 patients with and without the metabolic syndrome who underwent bariatric surgery over a 5-year period were obtained from the University HealthSystem Consortium database.
The prevalence of the metabolic syndrome among bariatric surgery patients was 27.4%. Patients with the metabolic syndrome presented significantly higher overall morbidity as compared to morbidly obese patients without the metabolic syndrome (8.6% vs. 5.8%; p < 0.01), and similar mortality (0.04% vs. 0.01%; p = 0.2) after bariatric surgery. Hispanics with the metabolic syndrome had the highest morbidity rates, and men had the uppermost mortality. In-hospital bariatric surgery outcomes were significantly improved among patients who underwent laparoscopic adjustable gastric banding.
The data suggest that the presence of the metabolic syndrome affects inter-ethnic and gender-specific short-term outcomes after bariatric surgery.
- SourceAvailable from: Martin P MintchevGastroenterology 142(5):S-13. DOI:10.1016/S0016-5085(12)60049-3 · 13.93 Impact Factor
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ABSTRACT: Bariatric surgery is expanding worldwide. In a previous study, we found a threefold increase in the annual incidence in Sweden between 1987 and 1996. The aim of the present study was to describe the nationwide practice of bariatric surgery until 2005 and determine the perioperative mortality. All bariatric procedures were identified through linkage to the Swedish Inpatient Registry, kept by the National Board of Health and Welfare. Mortality data were obtained from the Swedish National Death Registry A total of 8,129 bariatric procedures were identified. Seventy-eight percent of the patients were women and the mean age was 40.3 years. Hospital stay averaged 6 days. There was a 27% increase in the number of procedures performed in 2005 compared to 1995. After a decline in the beginning of the century, an increase of 119% is noted from 2001 to 2005. In the beginning of the study period, simple gastric restrictive procedures dominated (79%), but these procedures declined gradually. Gastric bypass has had the opposite development and reached 79% of all performed bariatric procedures in 2005. Laparoscopy has been introduced under the study period and in 2005, 42% of all gastric bypasses were performed by laparoscopy. The 30-day mortality was 0.16%. In spite of the shift to more complex procedures, the operative mortality was low.Obesity Surgery 11/2008; 19(12):1697-701. DOI:10.1007/s11695-008-9684-7 · 3.74 Impact Factor
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ABSTRACT: Contemporary life, with its sedentary lifestyles, fast foods, processed foodstuff, and desk-bound service employment, is beset by an epidemic of overweight and obese individuals. The World Health Organization reported that worldwide a billion adults are overweight and at least 30% of them are obese. Moreover, increasing numbers of children are obese. In the United States, 2 National Health and Nutrition Examination Surveys of adults aged 20 to 74 years showed that the prevalence of obesity increased from 15% in the 1976 to 1980 survey to 34% in the 2003 to 2004 survey. Obesity and the metabolic syndrome are unfortunately becoming increasingly common perioperative issues. The ultimate aim of caring for such patients is to find ways to minimize the untoward effects of surgery in patients who are obese or have metabolic syndrome.Anesthesiology Clinics 12/2009; 27(4):705-19. DOI:10.1016/j.anclin.2009.09.006