Kathleen L Simon, MD, Melissa C Helm, BS, Jon C Gould, MD. Medical College of Wisconsin
Introduction: Metabolic syndrome is commonly observed in patients with morbid obesity undergoing bariatric surgery. The purpose of this study was to determine the effect of metabolic syndrome on morbidity and mortality following bariatric surgery.
Methods and Procedures: We queried the National Surgical Quality Improvement Program (NSQIP) dataset for patients who underwent bariatric surgery between 2012 and 2014. Patient demographics, comorbidities, procedure type, and perioperative complications were examined. Metabolic syndrome was defined as having a body mass index >30 kg/m2 in the presence of hypertension and diabetes. Regression analysis was used to determine the relationship between metabolic syndrome and post-operative outcomes.
Results: During the study interval, there was 59,404 who underwent an included bariatric surgical procedure (Roux-en-Y gastric bypass = 28,263, sleeve gastrectomy =30,239, revision = 422, and biliopancreatic diversion = 480). The overall mean body mass index was 45 kg/m2, with a mean age of 45-years. 30,104 (50.6%) patients had a diagnosis of hypertension, 16,558 (27.8%) had diabetes mellitus, and 12,806 (21.5%) met the criteria for metabolic syndrome. Patients with metabolic syndrome were more likely to have Roux-en-Y gastric bypass (57.9% vs. 42.1%), a history of CHF, severe COPD, acute or chronic renal failure, dyspnea, and diminished functional status (p<0.0001). The overall observed incidence of post-operative complications was greater for patients with metabolic syndrome (7.5% vs. 5%; p<0.0001). The presence of metabolic syndrome was predictive of a patient having multiple 2 or more complications within 30-days of surgery (2.1% vs. 1.2%; OR 1.74; p<0.0001). Metabolic syndrome contributed to a 3.2-fold increased risk of post-operative death (p<0.0001).
Conclusions: Metabolic syndrome is prevalent in patients undergoing bariatric surgery nationwide. Patients with metabolic syndrome are at an increased risk of morbidity and mortality following bariatric surgery. The risk of experiencing more than 1 post-operative complication was also significantly elevated in patients with metabolic syndrome. Patients should be informed and surgeons should be aware of these increased risks.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79389
Program Number: P481
Presentation Session: Poster (Non CME)
Presentation Type: Poster