School of Medicine, Department of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, 94305, USA.
Department of Medicine, Morehouse School of Medicine, 720 Westview Dr. SW, Atlanta, GA, 30313, USA.
Obes Surg. 2023 Nov;33(11):3472-3486. doi: 10.1007/s11695-023-06833-7. Epub 2023 Oct 7.
The association between bariatric surgery and IBD-related inpatient outcomes is not well characterized. We report, analyze, and compare inpatient trends and outcomes among encounters with a history of bariatric surgery (Hx-MBS) compared to those receiving bariatric surgery during index admission (PR-MBS) admitted from 2009 to 2020.
Retrospective cohort design: the 2009-2020 National Inpatient Sample (NIS) databases were used to identify hospital encounters with patients aged ≥ 18 years with a history of MBS (Hx-MBS) or with procedure coding indicating MBS procedure (PR-MBS) according to International Classification of Diseases, Ninth (ICD-9-CM/ ICD-9-PCS) or Tenth Revision (ICD-10-CM/ICD-10-PCS) Clinical Modification/Procedure Coding System during index admission (ICD-9-CM: V4586; ICD-10-CM: Z9884; ICD-9-PR: 4382, 4389; ICD-10-PR: 0DB64Z3, 0DB63ZZ). Pearson χ2 analysis, analysis of variance, multivariable regression analyses, and propensity matching on independent variables were conducted to analyze significant associations between variables and for primary outcome inflammatory bowel disease-related admission, and secondary outcomes: diagnosis of nonalcoholic steatohepatitis, nonalcoholic fatty liver disease, or chronic mesenteric ischemia during admission.
We identified 3,365,784 (76.20%) Hx-MBS hospitalizations and 1,050,900 hospitalizations with PR-MBS (23.80%). Propensity score matching analysis demonstrated significantly higher odds of inflammatory bowel disease, and chronic mesenteric ischemia for Hx-MBS compared to PR-MBS, and significantly lower odds of nonalcoholic steatohepatitis and nonalcoholic fatty liver disease for Hx-MBS compared to PR-MBS.
In our study, Hx-MBS was associated with significantly increased odds of inflammatory bowel disease and other GI pathologies compared to matched controls. The mechanism by which this occurs is unclear. Additional studies are needed to examine these findings.
减重手术与 IBD 相关住院结局之间的关联尚未得到很好的描述。我们报告、分析和比较了 2009 年至 2020 年期间有减重手术史（Hx-MBS）和指数入院期间接受减重手术（PR-MBS）的入院患者的住院趋势和结局。
回顾性队列设计：使用 2009-2020 年国家住院患者样本（NIS）数据库，根据国际疾病分类，第九版（ICD-9-CM/ICD-9-PCS）或第十版（ICD-10-CM/ICD-10-PCS）临床修正/程序编码系统，确定年龄≥18 岁且有 MBS 史（Hx-MBS）或在指数入院时程序编码指示 MBS 程序（PR-MBS）的住院患者的住院患者。（ICD-9-CM：V4586；ICD-10-CM：Z9884；ICD-9-PR：4382、4389；ICD-10-PR：0DB64Z3、0DB63ZZ）。采用 Pearson χ2 分析、方差分析、多变量回归分析和独立变量的倾向性匹配分析，分析变量之间以及主要结局炎性肠病相关入院、次要结局：入院时非酒精性脂肪性肝炎、非酒精性脂肪性肝病或慢性肠系膜缺血之间的显著关联。
我们确定了 3365784 例（76.20%）Hx-MBS 住院和 1050900 例 PR-MBS 住院（23.80%）。倾向评分匹配分析表明，与 PR-MBS 相比，Hx-MBS 患者患炎性肠病和慢性肠系膜缺血的几率明显更高，而 Hx-MBS 患者患非酒精性脂肪性肝炎和非酒精性脂肪性肝病的几率明显低于 PR-MBS。
在我们的研究中，与匹配对照相比，Hx-MBS 与炎性肠病和其他胃肠道疾病的几率显著增加相关。发生这种情况的机制尚不清楚。需要进一步研究来检查这些发现。
