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Impact of Bariatric Surgery on Outcomes of Patients with Inflammatory Bowel Disease: a Nationwide Inpatient Sample Analysis, 2005–2018

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Abstract

Purpose

The global prevalence of inflammatory bowel disease (IBD) has steadily risen over the past few decades. Bariatric surgery stands out as an effective strategy for inducing weight loss. This study investigated the impacts of bariatric surgery on the clinical outcomes in patients with IBD.

Materials and Methods

Data of hospitalized patients aged ≥ 18 years with IBD were extracted from the Nationwide Inpatient Sample (NIS) 2005–2018. The patients were categorized according to whether they underwent bariatric surgery or not. Univariate and multivariable logistic regression analyses were performed to determine the associations between bariatric surgery, prolonged LOS, unfavorable discharge, hospital mortality, and morbidity.

Results

Data from 807,843 hospitalized patients with IBD were extracted. After exclusions and propensity-score matching, 80,545 patients were analyzed, with 16,109 undergoing bariatric surgery and 64,436 not. A total of 23% of patients had a prolonged LOS, 8% had unfavorable discharge, and the mortality rate was 1.2%. Multivariable analyses revealed that, compared to patients without bariatric surgery, patients with bariatric surgery had significantly decreased odds of prolonged LOS (adjusted odds ratio [aOR], 0.89; 95% CI 0.85-0.93), unfavorable discharge (aOR, 0.83; 95% CI: 0.77-0.89), and mortality (aOR, 0.54; 95% CI: 0.44–0.67), but had increased odds of morbidity (aOR, 1.09; 95% CI 1.04–1.13).

Conclusion

In adults with IBD, bariatric surgery is associated with favorable outcomes concerning hospital LOS, discharge status, and mortality. However, the risk of overall morbidity is slightly increased in those who received bariatric surgery compared to those who did not.

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Data Availability

All of the data supporting underlying findings are included in the manuscript and its supplemental files.

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Authors and Affiliations

  1. Division of Colorectal Surgery, Department of Surgery, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan

    I-Chen Lin

  2. Division of General Surgery, Department of Surgery, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi City, 600, Taiwan

    Hsien Liu

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  1. I-Chen Lin
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  2. Hsien Liu
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Correspondence to Hsien Liu.

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Key Points

• This study investigated the impact of bariatric surgery on hospitalization outcomes for patients with inflammatory bowel disease (IBD) using a large, nationally representative database.

• Bariatric surgery was independently associated with lower risks of prolonged LOS, unfavorable discharge, and hospital mortality.

• Patients who had received bariatric surgery were more likely to have morbidity during hospitalization than those who had not.

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Lin, IC., Liu, H. Impact of Bariatric Surgery on Outcomes of Patients with Inflammatory Bowel Disease: a Nationwide Inpatient Sample Analysis, 2005–2018. OBES SURG 34, 479–486 (2024). https://doi.org/10.1007/s11695-023-07023-1

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  • DOI: https://doi.org/10.1007/s11695-023-07023-1

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