Background

Metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease and increased mortality after bariatric surgery. The incidence of major adverse cardiovascular events (MACE) in patients with MetS undergoing bariatric surgery is not well characterized.

Methods

This retrospective cohort review studied 760,076 patients in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program datafiles between 2015 and 2018. MetS was defined in the cohort undergoing bariatric surgery as body mass index (BMI) >=35 kg/m2, hypertension, and diabetes mellitus. Demographics and comorbid conditions, operative-specific characteristics including the type of procedure, as well as 30-day outcomes were compared. Primary end points included the 3-component MACE (all-cause death, acute myocardial infarction (AMI) or cerebrovascular accident). Secondary outcomes included cardiac arrest requiring cardiopulmonary resuscitation, adverse events, length of stay, readmission, and reoperation.

Results

Of the 577,882 patients included in the study, 19.2%(111,128) had MetS. MACE was greater in the MetS cohort (0.3% vs 0.1%, p<0.001). Specifically, mortality (0.2% vs 0.1%, p<0.001), AMI (0.1% vs 0.0%, p<0.001) and cardiac arrest (0.1% vs 0.0%, p<0.001) occurred more frequently in the MetS group compared to non-MetS. Length of stay was longer in the Mets group along with higher readmission and reoperation rates compared to non-MetS (p<0.001). Furthermore, the MetS group experienced acute renal failure (0.2% vs 0.0%, p<0.001) and organ space surgical site infection (0.3% vs 0.1%, p<0.001) more often than the non-MetS patients.