Bariatric Surgery and Hospitalization for Heart Failure in Morbidly Obese Patients

Background: Bariatric surgery may improve heart failure outcome in morbidly obese patients. However, the safety of bariatric surgery has not been investigated in morbidly obese patients hospitalized for heart failure. We evaluated the effects of bariatric surgery on parameters of hospitalization for heart failure in morbidly obese patients.

Methods: We analyzed administrative discharge data of morbidly obese patients with heart failure as a primary diagnosis. Propensity score matching was performed to assess parameters of hospitalization in morbidly obese patients with and without a history of bariatric surgery. The discharges with diastolic heart failure codes were analyzed separately.

Results: Morbid obesity was coded in 4.4% of all discharges. Heart failure was the primary diagnosis in 6.0% of discharges with morbid obesity codes. Only 1% of discharges with morbid obesity and heart failure as primary diagnosis codes were coded for bariatric surgery. Length of stay (p < 0.001), in-hospital mortality (p < 0.001), and the estimated cost of hospitalizations (p < 0.007) were lower in discharges with than without bariatric surgery codes. Length of stay was shorter and in-hospital mortality was lower in discharges with codes for diastolic heart failure and bariatric surgery than with codes for only diastolic heart failure (p < 0.042 and p < 0.001 respectively).

Conclusion: When hospitalized for heart failure, morbidly obese patients who underwent bariatric surgery fare as well as or slightly better than their counterparts who did not.

Keywords: Bariatric surgery; Diastolic dysfunction; Heart failure; Hospitalizations; Mortality.