Early outcomes of bariatric surgery in patients with metabolic syndrome: An analysis of the bariatric outcomes longitudinal database

William B. Inabnet, Deborah A. Winegar, Bintu Sherif, Michael G. Sarr

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Background: Metabolic syndrome (MetS) complicating obesity is endemic in the United States. Study Design: Bariatric Outcomes Longitudinal Database, the national database for the American Society for Metabolic and Bariatric Surgery Bariatric Surgery Center of Excellence Program, was queried to identify patients undergoing bariatric surgery from June 2007 through November 2010. MetS was defined as the presence of hypertension, diabetes, and dyslipidemia at presentation for bariatric surgery. Ninety-day and 1-year outcomes were assessed to determine early outcomes in bariatric surgery patients with MetS. Results: Among 186,576 research-consented patients, 23,106 (12%) were diagnosed with MetS. Patients with MetS were more likely to be male (35% vs 20%; p < 0.0001), older (mean age 54 vs 44 years; p < 0.0001), and Caucasian (81% vs 74%; p < 0.0001). Of the 23,106 MetS patients, more underwent gastric bypass (RYGB) (62%) compared with gastric banding (32%), sleeve gastrectomy (4.5%), and biliopancreactic diversion with duodenal switch (BPD/DS)(1.5%). MetS patients had an increase in serious complications (2.4% vs 1.0%; p < 0.0001), readmissions (6.2% vs 4.7%; p < 0.0001), and mortality (0.3% vs 0.1%; p < 0.0001) within 90 days of operation. After adjusting for sex, age, and body mass index, RYGB patients with MetS had an increased risk of 90-day serious complications compared to RYGB patients without MetS (odds ratio 1.43; 95% CI, 1.27 to 1.61; p < 0.0001). The 12-month remission rate of diabetes was least for gastric banding (28%) compared with the other procedures (RYGB 62%, sleeve gastrectomy 52%, BPD/DS 74%). Conclusions: Patients with MetS undergoing bariatric surgery showed dramatic improvement in diabetes 1-year after surgery; however, an adverse 90-day outcome was more common.

Original languageEnglish (US)
Pages (from-to)550-556
Number of pages7
JournalJournal of the American College of Surgeons
Volume214
Issue number4
DOIs
StatePublished - Apr 2012

Fingerprint

Bariatrics
Bariatric Surgery
Databases
Gastrectomy
Stomach
Gastric Bypass
Dyslipidemias
Type 1 Diabetes Mellitus
Body Mass Index
Obesity
Odds Ratio
Hypertension

Keywords

  • American Society for Metabolic and Bariatric Surgery
  • ASMBS
  • Bariatric Outcomes Longitudinal Database
  • Bariatric Surgery Centers of Excellence
  • biliopancreatic diversion with duodenal switch
  • BMI
  • body mass index
  • BOLD
  • BPD/DS
  • BSCOE
  • metabolic syndrome
  • MetS
  • Roux-en-Y gastric bypass
  • RYGB

ASJC Scopus subject areas

  • Surgery

Cite this

Early outcomes of bariatric surgery in patients with metabolic syndrome : An analysis of the bariatric outcomes longitudinal database. / Inabnet, William B.; Winegar, Deborah A.; Sherif, Bintu; Sarr, Michael G.

In: Journal of the American College of Surgeons, Vol. 214, No. 4, 04.2012, p. 550-556.

Research output: Contribution to journalArticle

Inabnet, William B. ; Winegar, Deborah A. ; Sherif, Bintu ; Sarr, Michael G. / Early outcomes of bariatric surgery in patients with metabolic syndrome : An analysis of the bariatric outcomes longitudinal database. In: Journal of the American College of Surgeons. 2012 ; Vol. 214, No. 4. pp. 550-556.
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N2 - Background: Metabolic syndrome (MetS) complicating obesity is endemic in the United States. Study Design: Bariatric Outcomes Longitudinal Database, the national database for the American Society for Metabolic and Bariatric Surgery Bariatric Surgery Center of Excellence Program, was queried to identify patients undergoing bariatric surgery from June 2007 through November 2010. MetS was defined as the presence of hypertension, diabetes, and dyslipidemia at presentation for bariatric surgery. Ninety-day and 1-year outcomes were assessed to determine early outcomes in bariatric surgery patients with MetS. Results: Among 186,576 research-consented patients, 23,106 (12%) were diagnosed with MetS. Patients with MetS were more likely to be male (35% vs 20%; p < 0.0001), older (mean age 54 vs 44 years; p < 0.0001), and Caucasian (81% vs 74%; p < 0.0001). Of the 23,106 MetS patients, more underwent gastric bypass (RYGB) (62%) compared with gastric banding (32%), sleeve gastrectomy (4.5%), and biliopancreactic diversion with duodenal switch (BPD/DS)(1.5%). MetS patients had an increase in serious complications (2.4% vs 1.0%; p < 0.0001), readmissions (6.2% vs 4.7%; p < 0.0001), and mortality (0.3% vs 0.1%; p < 0.0001) within 90 days of operation. After adjusting for sex, age, and body mass index, RYGB patients with MetS had an increased risk of 90-day serious complications compared to RYGB patients without MetS (odds ratio 1.43; 95% CI, 1.27 to 1.61; p < 0.0001). The 12-month remission rate of diabetes was least for gastric banding (28%) compared with the other procedures (RYGB 62%, sleeve gastrectomy 52%, BPD/DS 74%). Conclusions: Patients with MetS undergoing bariatric surgery showed dramatic improvement in diabetes 1-year after surgery; however, an adverse 90-day outcome was more common.

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