Obesity can worsen outcomes in patients with chronic respiratory diseases. We aimed to determine the impact of rapid weight loss after bariatric surgery (BaS) on the risk of hospitalization due to acute exacerbation (AE) of chronic obstructive lung diseases (COLD's).


NIS data collected from 2010 to 2015 was examined. Patients were classified as treatment and control groups. Treatment subjects were defined as patients with previous history of BaS, and control subjects as patients with BMI >= 35 Kg/m2, without history of BaS. The primary outcome was hospitalization due to AE of any COLD's (COPD, asthma and bronchiectasis), the secondary outcome was the total length of stay (LOS). Univariate analysis and multivariate regression model were performed to assess the difference in outcomes between groups


We included a total of 2,300,845 subjects: 2,004,804 controls and 296,041 treatments. Univariate analysis showed that the hospitalization rate was significantly lower for the treatment group compared to the control group (3.7% vs. 9.8%, p<0.0001), confirmed after adjusting for covariables (control vs. treatment: OR = 2.46, p<0.0001). Subgroup analysis showed that the treatment group had a lower risk of LOS >= 3 days compared to controls (69.8% vs. 77.4%, p<0.0001), confirmed by multivariate analysis (control vs. treatment: OR = 1.40, p<0.0001).


BaS may decrease the risk of hospitalization due to AE in patients with COLD's, also decreasing the LOS. We acknowledge that this comparison is limited by the nature of the database, hence further prospective studies are needed to better understand these results.