Author + information
- Yuichi J. Shimada,
- Koichiro Gibo,
- Hiroyasu Iso,
- David Brown and
- Kohei Hasegawa
Background: Although studies have suggested links between obesity and morbidities related to cardiovascular disease (CVD), little is known about whether substantial weight reduction affects the risk and cost of CVD-related healthcare utilizations. We aimed to determine whether bariatric surgery is associated with decreased risk and cost of CVD-related healthcare utilizations, and to investigate changes in the risk after bariatric surgery by CVD category (e.g., coronary atherosclerosis [CAD], heart failure [HF], dysrhythmia).
Methods: We performed a self-controlled case series study in obese adults with CVD who underwent bariatric surgery using population-based emergency department (ED) and inpatient sample in California and Florida. The primary outcome was ED visit or hospitalization for CVD from 2005 to 2011. We used conditional logistic regression to compare the risk of outcome during sequential 12-month periods, using pre-surgery months 13-24 as the reference period. We also examined the risk of healthcare utilizations for each CVD category. The secondary outcome was annualized direct costs of CVD-related hospitalizations.
Results: We identified 11,106 obese adults with CVD who underwent bariatric surgery. During the reference period, 20.6% (95% confidence interval [CI], 19.8%-21.3%) of patients had an ED visit or hospitalization for CVD. The risk did not significantly change in the subsequent 12-month pre-surgery period (adjusted odds ratio [aOR] 0.98; 95%CI, 0.93-1.04; P=0.42). By contrast, in the first 12 month post-surgery period, the risk significantly decreased (aOR 0.91; 95%CI, 0.86-0.96; P=0.002). The risk remained reduced in the subsequent 13-24 months after bariatric surgery (aOR 0.84; 95%CI, 0.79-0.89; P<0.001). By CVD category, the risk of healthcare utilization for CAD, HF, and hypertension decreased, whereas that of dysrhythmia and venous thromboembolism increased, after bariatric surgery (all P<0.05). The total annualized cost declined from $16.7 to $12.0 million after bariatric surgery.
Conclusions: Bariatric surgery is associated with a lower risk of CVD-related ED visit or hospitalization and a decreased inpatient cost for CVD among obese adults.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Updates on Risk Factors for Cardiovascular Disease
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1187-062
- 2017 American College of Cardiology Foundation