PhD Program in Nutrition and Food Science, Fu Jen Catholic University, New Taipei City, Taiwan.
Department of General Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Obes Surg. 2024 Sep;34(9):3258-3265. doi: 10.1007/s11695-024-07115-6. Epub 2024 Jul 24.
Acute allergic reactions may occur in susceptible individuals following exposure to various allergens. Obesity is linked to allergic reactions, and weight loss from bariatric surgery may attenuate the severity of certain conditions such as airway hyperresponsiveness in asthma. This retrospective observational study investigates associations between prior bariatric surgery and lower risk for life-threatening conditions in patients hospitalized with acute allergic reactions and anaphylaxis.
Adults ≥ 18 years old diagnosed with morbid obesity and admitted to US hospitals with acute allergic reactions/anaphylaxis were included. All data were extracted from the US Nationwide Inpatient Sample (NIS) database 2005-2018. Patients without information on in-hospital mortality, discharge destination, hospital costs, and length of stay (LOS) were excluded. Patients were divided into two groups based on prior bariatric surgery or not. All diagnoses were verified through ICD-9 and ICD-10 codes. Between-group differences and associations between variables were evaluated using logistic regression analysis.
After matching, patients with prior bariatric surgery had significantly lower proportions of any life-threatening morbidity (37.2% vs. 47.4%), respiratory distress or failure (11.2% vs. 17.0%), pneumonia or severe infection (7.4% vs. 10.2%), sepsis/septic shock (15.2% vs. 20.9%), intubation and mechanical ventilation (11.2% vs. 14.6%), prolonged LOS (10.3% vs. 20.6%) and unfavorable discharge (6.9% vs. 12.5%) than those without prior bariatric surgery.
Prior bariatric surgery predicts a lower risk of life-threatening morbidity and prolonged LOS among adults hospitalized for acute allergic reaction and anaphylaxis. Future prospective studies are warranted to confirm the present findings and reveal underlying mechanisms.
在接触各种过敏原后，易感个体可能会发生急性过敏反应。肥胖与过敏反应有关，减重手术（如减肥手术）引起的体重减轻可能会减轻某些疾病的严重程度，例如哮喘中的气道高反应性。本回顾性观察性研究调查了既往减重手术与因急性过敏反应和过敏反应而住院的患者发生危及生命的疾病的风险降低之间的关联。
纳入年龄≥18 岁且被诊断为病态肥胖并因急性过敏反应/过敏反应入住美国医院的成年人。所有数据均从 2005 年至 2018 年的美国全国住院患者样本（NIS）数据库中提取。排除无住院死亡率、出院去向、住院费用和住院时间（LOS）信息的患者。根据是否进行过减重手术将患者分为两组。通过 ICD-9 和 ICD-10 代码验证所有诊断。使用逻辑回归分析评估组间差异和变量之间的关联。
在匹配后，有既往减重手术史的患者出现任何危及生命的发病率（37.2% vs. 47.4%）、呼吸窘迫或衰竭（11.2% vs. 17.0%）、肺炎或严重感染（7.4% vs. 10.2%）、脓毒症/感染性休克（15.2% vs. 20.9%）、插管和机械通气（11.2% vs. 14.6%）、住院时间延长（10.3% vs. 20.6%）和预后不良（6.9% vs. 12.5%）的比例明显较低。
既往减重手术可预测因急性过敏反应和过敏反应住院的成年人发生危及生命的发病率和 LOS 延长的风险降低。需要进一步的前瞻性研究来证实目前的发现并揭示潜在机制。
