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Decreased Long-Term Respiratory Infection Risk After Bariatric Surgery: a Comprehensive National Cohort Study

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Abstract

Purpose

This study aims to determine whether bariatric surgery (BS) decreases the risk of respiratory tract infections (RTIs) in obese patients.

Materials and Methods

This retrospective, population-based, matched cohort study utilized data from the Taiwan National Health Insurance Research Database. All patients 18 to 55 years of age with obesity diagnosed between 2005 and 2010 were enrolled. Patients were separated into two groups based on whether they underwent BS. Two groups were selected using 1:1 propensity score matching according to age, sex, and comorbidities. The general population was also enrolled for comparison. The primary endpoint was the incidence of RTIs, including pneumonia, influenza, and bronchitis. All patients were followed up until the end of 2013, the primary endpoint, or death.

Results

Compared to the non-surgery group, the BS group was at significantly lower risk for RTIs (aHR 0.432, 95% CI 0.340–0.549, p < 0.001) with shorter length of hospital stay (LOH) and lower cost. Regardless of the RTI-related mortality, pneumonia, influenza, and bronchitis rates, BS did have significant protective effects on the non-surgery group. Compared to the general population, the BS group was at higher risk for RTIs (aHR 3.601, 95% CI 2.742–4.728, p < 0.001) with similar LOH and lower cost.

Conclusion

Patients with obesity who underwent BS were at significantly lower risk for RTIs than obese patients who did not undergo BS but were at higher risk for RTIs than the general population. BS may result in a long-term reduction of the RTI risk.

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Acknowledgments

This study is based in part on data from National Health Insurance Research Database (NHIRD), provided by the National Health Insurance Administration, Ministry of Health and Welfare and managed by the National Health Research Institutes (registered number NHIRD-103-246). The data utilized in this study cannot be made available in the manuscript, the supplemental files, or in a public repository due to the “Personal Information Protection Act” executed by Taiwan’s government, starting from 2012. Requests for data can be sent as a formal proposal to the NHIRD (http://nhird.nhri.org.tw) or by email to nhird@nhri.org.tw.

Funding

This work was supported by the E-da Hospital Research Foundation (EDAHP-107-011, EDAHI-109-001).

Author information

Authors and Affiliations

  1. Bariatric and Metabolic International Surgery Center, Department of General Surgery, E-Da Hospital, No. 1, Yida Rd., Yanchao Dist., Kaohsiung City, 824, Taiwan, Republic of China

    Jian-Han Chen, Chung-Yen Chen & Wei-Leng Chin

  2. Division of General Surgery, E-Da Hospital, Kaohsiung City, Taiwan

    Jian-Han Chen & Chung-Yen Chen

  3. School of Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan

    Jian-Han Chen, Yu-Feng Wei, Chung-Yen Chen & Ho-Shen Lee

  4. School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan

    Jian-Han Chen, Chung-Yen Chen & Yu-Chieh Su

  5. Division of Chest Medicine, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan

    Yu-Feng Wei & Ho-Shen Lee

  6. Division of Hematology-Oncology, E-Da Hospital, Kaohsiung, Taiwan

    Yu-Chieh Su

  7. Department of Respiratory Medicine, Kaohsiung Municipal Gangshan Hospital, Kaohsiung, Taiwan

    Robert Shan Fon Tsai

  8. Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan

    Wei-Leng Chin

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  1. Jian-Han Chen
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All authors have seen and approved the manuscript.

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Correspondence to Jian-Han Chen.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The present study was thoroughly evaluated and approved by the Institutional Review Board of E-Da Hospital (approval EMRP-106-063) and informed consent does not apply.

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The authors declare that they have no conflict of interest.

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Chen, JH., Wei, YF., Chen, CY. et al. Decreased Long-Term Respiratory Infection Risk After Bariatric Surgery: a Comprehensive National Cohort Study. OBES SURG 31, 499–507 (2021). https://doi.org/10.1007/s11695-020-05001-5

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  • DOI: https://doi.org/10.1007/s11695-020-05001-5

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