Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.
Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, New York.
Surg Obes Relat Dis. 2021 Mar;17(3):489-497. doi: 10.1016/j.soard.2020.11.014. Epub 2020 Nov 20.
Heart failure is a disease with significant healthcare utilization and a prioritized target for readmission prevention. Although obesity is related to heart failure morbidity, the effects of bariatric surgery in obese patients with heart failure are not well studied.
To evaluate the impact of bariatric surgery on hospital-based healthcare utilization for patients with heart failure.
Administrative statewide database.
The New York Statewide Planning and Research Cooperative System database was used to identify patients with obesity and heart failure who underwent bariatric surgery from 2005 to 2015. Emergency department (ED) visits and hospitalization records from 1 year presurgery and up to 2 years postsurgery were compared.
Our study identified 899 patients with heart failure who underwent bariatric surgery. In the year presurgery, 11.48% of patients had any ED visit or hospitalization with a primary diagnosis of heart failure. The rate decreased drastically in the first year after surgery, with only 3.70% of patients having any heart failure-related hospital visits. The rate of heart failure-related visits was also lower in the second year postsurgery (3.44%) compared with the year before surgery. The risk of heart failure-related hospital visits was lower in both the first year (odds ratio [OR], .29; 95% confidence interval [CI], .19-.43) and second year postsurgery (OR, .26; 95% CI, .17-.41; P < .0001) than in the year before surgery.
These findings suggest that bariatric interventions might be associated with decreased risks of ED visits or hospitalizations due to heart failure exacerbations in obese patients with preexisting heart failure.
心力衰竭是一种医疗资源消耗量大的疾病，也是优先预防再入院的目标。尽管肥胖与心力衰竭的发病率有关，但肥胖合并心力衰竭患者接受减重手术的效果尚未得到充分研究。
评估减重手术对心力衰竭患者基于医院的医疗保健利用的影响。
全州行政数据库。
使用纽约州规划和研究合作系统数据库，确定 2005 年至 2015 年间接受减重手术的肥胖合并心力衰竭患者。比较术前 1 年至术后 2 年内的急诊就诊和住院记录。
我们的研究确定了 899 例心力衰竭患者接受了减重手术。在术前 1 年，11.48%的患者因心力衰竭的主要诊断而有任何急诊就诊或住院记录。手术后第一年，这一比例急剧下降，只有 3.70%的患者有任何与心力衰竭相关的住院就诊。与术前相比，术后第二年（3.44%）与心力衰竭相关的就诊率也较低。心力衰竭相关住院就诊的风险在术后第一年（优势比 [OR]，0.29；95%置信区间 [CI]，0.19-0.43）和第二年（OR，0.26；95% CI，0.17-0.41；P<0.0001）均低于术前。
这些发现表明，减重干预可能与肥胖合并心力衰竭的患者因心力衰竭恶化而导致急诊就诊或住院的风险降低有关。
