Bariatric surgery associated with lower mortality, health care cost in patients with MASLD
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Key takeaways:
- Inpatient mortality, length of hospital stay and cost were lower among patients with MASLD who underwent bariatric surgery.
- They also had fewer complications, such as acute kidney injury and acute heart failure.
WASHINGTON — Bariatric surgery was associated with improved clinical outcomes and more cost-effective health care resource utilization among patients with metabolic dysfunction-associated steatotic liver disease, according to data.
“Right now, obesity and the metabolic consequences, which include NAFLD, are continuing to increase every year,” Rayna Patel, MD, a second-year internal medicine resident at the University of Toledo, said at Digestive Disease Week. “NALFD is now affecting about 30% of the population worldwide and is the most common cause of chronic liver disease worldwide.”
She continued, “Lifestyle modifications, including weight loss, changes in dietary composition and exercising, do reduce liver injury and NAFLD in patients. Bariatric surgery is an intervention that can be done that leads to significant long-term weight loss as well.”
In a retrospective analysis, Patel and colleagues used the National Inpatient Sample database of the Healthcare Utilization Project to compare clinical outcomes associated with bariatric surgery among adult patients with MASLD, formerly known as NAFLD. Outcomes of interest included in-hospital mortality, hospital length of stay and total hospital cost.
Researchers identified 122,275 patients with MASLD, of whom 1,259 underwent bariatric surgery (mean age, 47 years; 83% women) in 2020 and 121,016 did not (mean age, 62 years; 61% women).
According to results, inpatient mortality was significantly lower among those who underwent surgery compared with those who did not (< 1% vs. 4.2%; P = .007); length of hospital stay (2.7 days vs. 6 days) and cost of hospitalization ($74,516 vs. $77,430) also was lower.
In addition, the bariatric surgery group had fewer complications, including acute kidney injury (4.6% vs. 30%; adjusted OR = 0.24; 95% CI, 0.13-0.43) and acute heart failure (1.9% vs. 13%; aOR = 0.49; 95% CI, 0.18-1.4).
“Evaluating the role of bariatric surgery in NAFLD patients will be interesting, as new medications are being introduced that can help treat NAFLD,” Patel said.
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Patel R, et al. Impact of bariatric surgery on hospital outcomes in patients admitted with nonalcoholic fatty liver disease: A 2020 retrospective analysis in the United States. Presented at: Digestive Disease Week; May 18-21, 2024; Washington (hybrid).
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