Bariatric surgery decreases the number of future hospital admissions for diastolic heart failure in subjects with severe obesity. Retrospective analysis of the US national inpatient sample (NIS) database.

ABSTRACT BACKGROUND Considerable evidence documents the effectiveness and efficacy of bariatric surgery (BaS) in reducing the prevalence and severity of obesity-related comorbidities. Diastolic heart failure (DHF) is a condition with considerable morbidity and mortality, yet recalcitrant to medical-therapy. Our objectives were to assess whether BaS is associated with a decrease in hospital admissions for DHF; and further assess its impact upon DHF hospital admissions among patients with hypertension (HTN) and coronary artery disease (CAD). METHODS Data on 296,041 BaS-cases and 2,004,804 severely obese controls were extracted from the US National Inpatient Sample (NIS) database for the years 2010—2015 and compared. Univariate and multivariable analysis were performed to assess the impact of pre-2010 BaS on the rate of hospital-admissions for DHF, adjusting for demographics, comorbidities, and other risk factors associated with cardiovascular disease (CVD). RESULTS Relative to controls, all baseline CVD risk factors were less common among BaS cases. Nonetheless, even after adjusting for all CVD risk factors, controls exhibited marked increases in the odds of DHF overall (OR=2.80; 95% CI=2.52—3.10). Controls with HTN and CAD demonstrated an almost threefold increase in odds of DHF admissions. Similarly, controls with no HTN demonstrated a fivefold increase in odds of admissions for DHF when compared to the surgical group. CONCLUSIONS In this retrospective, case-control study of a large, representative national sample of severely obese patients, BaS was found to be associated with significantly reduced hospitalizations for DHF when adjusted for baseline CVD risk factors. It also reduced DHF incidence in high-risk patients with HTN and CAD.