Department of Surgery, Rush University Medical Center, Chicago, Illinois.
Department of Surgery, Rush University Medical Center, Chicago, Illinois.
Surg Obes Relat Dis. 2021 Dec;17(12):1949-1955. doi: 10.1016/j.soard.2021.09.006. Epub 2021 Sep 10.
Metabolic and bariatric surgery (MBS) has demonstrated improvements in diabetes and cardiovascular health. The effect of MBS on the risk of ischemic stroke remains unclear.
The goal of this study was to determine the risk of stroke following MBS compared with patients with obesity who qualified for but did not undergo MBS.
The Mariner Database, a national claims database.
We identified patients with body mass index (BMI) ≥40 or those with a BMI and a qualifying co-morbidity, who underwent MBS between 2010 to 2019. Similar patients who did not undergo MBS served as controls. Coarsened exact matching was performed followed by logistic regression analysis to determine the effect of BMS on stroke risk.
A total of 70 622 BMS patients and 1 320 182 MBS-eligible controls were identified. After matching, the 1-year stroke risk among MBS patients (n = 56 514) versus controls (n = 56 514) was .6% versus 1.2% (OR .54, 95% CI .47-.61). The 5-year stroke risk for MBS (n = 27619) versus control (n = 27619) was 2.8% versus 3.6% (OR .78, 95% CI .65-.90).
MBS appears to reduce the risk of stroke following surgery. To our knowledge, this is the largest sample size in a study of ischemic cerebrovascular disease in bariatric surgery.
代谢和减重手术（MBS）已证明可改善糖尿病和心血管健康。MBS 对缺血性中风风险的影响尚不清楚。
本研究旨在确定与有资格接受但未接受 MBS 的肥胖患者相比，MBS 后中风的风险。
Mariner 数据库，一个全国性的索赔数据库。
我们确定了体重指数（BMI）≥40 或 BMI 伴有合格合并症的患者，他们在 2010 年至 2019 年间接受了 MBS。未接受 MBS 的类似患者作为对照。进行了粗化精确匹配，然后进行逻辑回归分析，以确定 MBS 对中风风险的影响。
共确定了 70622 例 MBS 患者和 1320182 例 MBS 合格对照。匹配后，MBS 患者（n=56514）与对照（n=56514）的 1 年中风风险分别为 0.6%和 1.2%（OR.54，95%CI.47-.61）。MBS（n=27619）与对照（n=27619）的 5 年中风风险分别为 2.8%和 3.6%（OR.78，95%CI.65-.90）。
MBS 似乎可降低手术后中风的风险。据我们所知，这是肥胖症手术中缺血性脑血管病研究中最大的样本量。
