Outcomes of cardiac arrest hospitalizations in patients with obesity with versus without prior bariatric surgery status:A nationwide propensity-matched analysis.

Autor:	Desai R; Independent Researcher, Atlanta, GA, USA., Gandhi Z; Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, PA, USA., Ravalani A; Department of Internal Medicine, Saint Agnes Hospital, Baltimore, MD, USA., Mahfooz K; Department of Internal Medicine, Lincoln Medical Center, New York, NY, USA., Mansuri U; Department of Internal Medicine, Medstar Harbor hospital, Baltimore, MD, USA., Jain A; Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA., Vyas A; Division of Vascular Medicine, Ochsner Health, New Orleans, LA, USA., Gupta R; Consultant Cardiologist, Spectrum Medical Center and Burjeel Royal Hospital, Al Ain, United Arab Emirates., Lavie CJ; John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Cardiovascular risk and prevention [Int J Cardiol Cardiovasc Risk Prev] 2023 Dec 22; Vol. 20, pp. 200235. Date of Electronic Publication: 2023 Dec 22 (Print Publication: 2024).
DOI:	10.1016/j.ijcrp.2023.200235
Abstrakt:	Introduction: Prior bariatric surgery (PBS) status in obese patients is thought to curtail the risk of cardiovascular events, but its role in change of outcomes of patients with obesity developing new acute cardiac events such as cardiac arrests (CA) remains largely unknown. Methods: Hospitalizations among adult patients with obesity and CA were identified retrospectively using the National Inpatient Sample (2015 October-2017 December). Propensity-matched analysis (1:1) was performed for sociodemographic/hospital characteristics to identify two cohorts, with (PBS+) or without (PBS-) status. The primary endpoint was in-hospital mortality, and the secondary endpoint was healthcare resource utilization. Results: Both cohorts (n = 1275 each), had patients with comparable age (mean 58 years), with a higher frequency of white (>70 %), females (>60 %), and Medicare enrollees (>40 %). PBS + cohort had lower rates of diabetes (27.8 % vs 36.1 %), hyperlipidemia (33.7 % vs 48.6 %), renal failure (17.3 % vs 22.0 %), chronic pulmonary disease (11.8 % vs 21.2 %) and higher rates of anemias (18.4 % vs 12.2 %), liver disease (5.1 % vs 2.4 %) and alcohol abuse (6.7 % vs 2.4 %) than PBS- cohort (p < 0.05). All-cause mortality (46.3 % vs 45.1 %, p = 0.551) was comparable between the two cohorts. The PBS + cohort was less often transferred routinely (p<0.001) but had a shorter hospital stay (p<0.001) with equivalent hospital charges compared to the PBS- cohort. Conclusions: The PBS status (regardless of chronology) did not increase survival in CA admissions among patients with obesity. Preventive measures are necessary to manage enduring cardiovascular disease risk factors that may limit the advantages of surgery for patients with obesity and aggravate the worse outcomes of future cardiac events. (© 2023 The Authors. Published by Elsevier B.V.)
Databáze:	MEDLINE
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