Abstract
Objectives
The objectives of this study were to characterize the prevalence of atrial dysrhythmias
for elective bariatric surgery patients and to explore their impact on postoperative
outcomes.
Setting
Data was extracted from the North American Metabolic and Bariatric Surgery Accreditation
and Quality Improvement Program (MBSAQIP) data registry from 2015 to 2019.
Methods
All primary Roux-en-Y gastric bypass and sleeve gastrectomy procedures were included.
Patients with atrial dysrhythmias (ADs) were identified as patients coded as receiving
preoperative therapeutic anticoagulation without a prior history of deep vein thrombosis,
venous thromboembolism, pulmonary embolism, or other conditions requiring anticoagulation.
Multivariable logistic regression analysis was used to determine the impact of preoperative
ADs on postoperative complications and 30-day mortality.
Results
We evaluated 731,981 patients, of whom 13,591 (1.9%) had preoperative ADs. Patients
with ADs were more likely to be older, have a higher body mass index, and be male.
Metabolic co-morbidities also were more common in those with ADs, as demonstrated
by the higher rates of medication use and insulin-dependent diabetes, hypertension,
dyslipidemia, and sleep apnea. After adjusting for co-morbidities using multivariable
logistic regression, AD was the single greatest independent predictor of serious complications
and 30-day mortality.
Conclusions
ADs were observed in approximately 2% of MBSAQIP patients. ADs are among the greatest
independent predictors of serious complications and mortality, suggesting that these
patients are associated with a higher perioperative risk profile warranting further
optimization.
Keywords
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Article info
Publication history
Published online: September 14, 2022
Accepted:
August 30,
2022
Received:
June 6,
2022
Identification
Copyright
© 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
