PhD Program in Nutrition and Food Science, Fu Jen Catholic University, New Taipei City, Taiwan; Department of General Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Department of General Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Surg Obes Relat Dis. 2023 Dec;19(12):1382-1390. doi: 10.1016/j.soard.2023.06.006. Epub 2023 Jun 28.
Systemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects young women, has many different manifestations, and the disease severity can wax and wane.
This study aims to determine the association between prior bariatric surgery and SLE outcomes.
A population-based, retrospective study using data from the U.S. Nationwide Inpatient Sample (NIS) database between 2005 and 2018.
Data of hospitalized patients with SLE and morbid obesity were extracted. Exclusion criteria were age <18 years and missing information on mortality. Patients were separated into 2 groups: with or without prior bariatric surgery. One: 4 propensity score matching (PSM) were performed to balance the characteristics between the groups. Associations between prior bariatric surgery and inpatient outcomes were determined by logistic regressions.
A total of 38,286 hospitalized patients with SLE and morbid obesity were identified. After exclusions and PSM, there remained 9050 subjects in the study sample (with prior bariatric surgery: 1810; without prior bariatric surgery: 7240), representing 44,952 U.S. inpatients. After adjusting for confounders in multivariable analysis, prior bariatric surgery was significantly associated with lower odds for prolonged length of stay (LOS), unfavorable discharge, and SLE-related complications. Specifically, prior bariatric surgery was significantly associated with lower risks of acute myocardial infarction (AMI)/stroke (aOR = .44, 95% CI: .30-.65), venous thromboembolism (VTE) (aOR = .74, 95% CI: .57-.96), pneumonia (aOR = .60, 95% CI: .47-.76), sepsis (aOR = .62, 95% CI: .51-.75), acute and chronic glomerulonephritis (aOR = .53, 95% CI: .38-.76), acute kidney injury (AKI) (aOR = .64, 95% CI: .52-.77), and anemia (aOR = .77, 95% CI: .68-.87).
Prior bariatric surgery is associated with favorable in-hospital outcomes in hospitalized patients with SLE and decreased likelihood for several SLE-related complications.
系统性红斑狼疮（SLE）是一种自身免疫性疾病，主要影响年轻女性，具有多种不同的表现，疾病严重程度可时轻时重。
本研究旨在确定减肥手术与 SLE 结局之间的关联。
这是一项基于人群的回顾性研究，使用了 2005 年至 2018 年美国全国住院患者样本（NIS）数据库中的数据。
提取了患有 SLE 和病态肥胖的住院患者的数据。排除标准为年龄<18 岁和死亡信息缺失。患者分为 2 组：有减肥手术和无减肥手术。一：进行了 4 次倾向评分匹配（PSM）以平衡组间特征。通过逻辑回归确定减肥手术与住院结局之间的关联。
共确定了 38286 例患有 SLE 和病态肥胖的住院患者。排除和 PSM 后，研究样本中仍有 9050 例患者（有减肥手术：1810 例；无减肥手术：7240 例），代表了 44952 例美国住院患者。在多变量分析中调整混杂因素后，减肥手术与延长住院时间（LOS）、不良出院和 SLE 相关并发症的可能性降低显著相关。具体而言，减肥手术与急性心肌梗死（AMI）/中风（aOR=0.44，95%CI：0.30-0.65）、静脉血栓栓塞症（VTE）（aOR=0.74，95%CI：0.57-0.96）、肺炎（aOR=0.60，95%CI：0.47-0.76）、败血症（aOR=0.62，95%CI：0.51-0.75）、急性和慢性肾小球肾炎（aOR=0.53，95%CI：0.38-0.76）、急性肾损伤（AKI）（aOR=0.64，95%CI：0.52-0.77）和贫血（aOR=0.77，95%CI：0.68-0.87）的风险降低显著相关。
减肥手术与 SLE 住院患者的住院期间结局改善相关，并降低了几种与 SLE 相关的并发症的发生几率。
