Impact of Bariatric Surgery on Clinical Outcomes in Metabolic Liver Disease - EMJ

Impact of Bariatric Surgery on Clinical Outcomes in Metabolic Liver Disease

1 Mins
Hepatology

NEW data reveals that bariatric surgery is linked to improvements in clinical outcomes and is a more cost-effective healthcare intervention for patients with metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD, previously referred to as non-alcoholic fatty liver disease, is estimated to affect more than 30% of the worldwide population, with incidence increasing annually, representing the most common cause of chronic liver disease. Several lifestyle interventions, including modifications to diet, exercise, and weight loss, can reduce MASLD and liver injury.  Bariatric surgery is a procedure that can enable significant long-term weight loss. It is typically performed when diet or exercise is insufficient, or the patient suffers from a severe health problem because of their weight, such as MASLD. Researchers wanted to understand the impact of bariatric surgery on clinical outcomes in MASLD patients and conducted a retrospective analysis to investigate the relationship.   

The study cohort used to compare clinical outcomes associated with bariatric surgery in MASLD adult patients was the National Inpatient Sample database of the Healthcare Utilization Project. Within the database, 122,275 patients had a MASLD diagnosis, of which 1,259 underwent bariatric surgery in 2020 (mean age, 47 years; 83% women). Clinical outcomes examined in this study included hospital mortality, cost of total hospital care, and length of hospital stay.   

The findings presented at Digestive Disease Week in Washington demonstrated that for MASLD patients who underwent bariatric surgery, there was a significant reduction in inpatient mortality compared to patients who did not receive bariatric surgery (<1% vs. 4.2%; p=0.007). The cost of care during hospitalisation and time spent in the hospital (2.7 days vs. 6 days) were lower in patients who underwent bariatric surgery. Furthermore, the bariatric surgery patient group was associated with reduced acute kidney injury (4.6% vs 30%; adjusted odds ratio [OR]=0.24; 95% confidence interval [CI], 0.13-0.43)   and acute heart failure complications (1.9% vs 13%; aOR=0.49; 95% CI, 0.18-1.4).  

These findings prompted the researchers to conclude that, with the development of new MASLD medications, continued research evaluating the role of bariatric surgery in treating MASLD patients holds significant potential.  

Reference: 

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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