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Bariatric surgery increases risk for acute liver injury

CHICAGO — Bariatric surgery increases the risk of subsequent acute liver injury, according to results of a study presented at Digestive Disease Week.

“Bariatric surgery provides a durable and effective method of weight loss and it’s on the rise given the fact that obesity is on the rise, but it does come with its associated adverse events,” Praneet Wander, MD, from Mount Sinai St. Luke’s, New York, said in a presentation. “Some studies have reported an increase in acute liver injury following bariatric surgery. Since acute liver injury is an uncommon but fatal condition, the aim of our study was to assess if history of bariatric surgery increases the risk of acute liver injury in a large patient cohort.”

The researchers identified 437,390 patients who presented with acute liver injury (ALI) between 2010 and 2013. These patients were divided into a non-surgery group and a surgery group of 3,799 patients who had undergone bariatric surgery. Mean patient age was 58.7 years and 77% were women.

Compared with the non-surgery group, patients who presented with ALI and had a history of bariatric surgery were more likely to be in a lower age bracket of 25 to 49 years, female, white, residing in more affluent regions, had private medical insurance and had a lower Charlson comorbidity index (P < .01).

Additionally, patients in the surgery group had higher rates of malnutrition (P < .01), anemia (P < .01) and alcoholism (P = .05), and lower rates of hepatitis B (P = .02), hepatitis C (P < .01), congestive heart failure (P < .01), chronic kidney disease (P < .01), diabetes (P < .01) and coagulopathy (P < .01).

Acute liver injury rate was 0.85% in the surgery group compared with a rate of 0.72% in the non-surgery group (P < .01). Patients in the surgery group had 11.3% higher mortality risk compared with patients with no acute liver injury, while patients in the non-surgery group had a 6.17% higher mortality risk in the same comparison. Age, African-American ethnicity, chronic heart failure and coagulopathy were also associated with increased mortality risk in this cohort.

“Bariatric surgery increases the risk of subsequent acute liver injury and mortality associated with acute liver injury,” Wander concluded. “Addressing modifiable risk factors, such as anemia, malnutrition and alcoholism, in post-bariatric surgery population will decrease the significant morbidity and mortality of acute liver injury.” – by Talitha Bennett

References:

Wander P, et al. Abstract 278. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Disclosure : Wander reports no relevant financial disclosures.

CHICAGO — Bariatric surgery increases the risk of subsequent acute liver injury, according to results of a study presented at Digestive Disease Week.

“Bariatric surgery provides a durable and effective method of weight loss and it’s on the rise given the fact that obesity is on the rise, but it does come with its associated adverse events,” Praneet Wander, MD, from Mount Sinai St. Luke’s, New York, said in a presentation. “Some studies have reported an increase in acute liver injury following bariatric surgery. Since acute liver injury is an uncommon but fatal condition, the aim of our study was to assess if history of bariatric surgery increases the risk of acute liver injury in a large patient cohort.”

The researchers identified 437,390 patients who presented with acute liver injury (ALI) between 2010 and 2013. These patients were divided into a non-surgery group and a surgery group of 3,799 patients who had undergone bariatric surgery. Mean patient age was 58.7 years and 77% were women.

Compared with the non-surgery group, patients who presented with ALI and had a history of bariatric surgery were more likely to be in a lower age bracket of 25 to 49 years, female, white, residing in more affluent regions, had private medical insurance and had a lower Charlson comorbidity index (P < .01).

Additionally, patients in the surgery group had higher rates of malnutrition (P < .01), anemia (P < .01) and alcoholism (P = .05), and lower rates of hepatitis B (P = .02), hepatitis C (P < .01), congestive heart failure (P < .01), chronic kidney disease (P < .01), diabetes (P < .01) and coagulopathy (P < .01).

Acute liver injury rate was 0.85% in the surgery group compared with a rate of 0.72% in the non-surgery group (P < .01). Patients in the surgery group had 11.3% higher mortality risk compared with patients with no acute liver injury, while patients in the non-surgery group had a 6.17% higher mortality risk in the same comparison. Age, African-American ethnicity, chronic heart failure and coagulopathy were also associated with increased mortality risk in this cohort.

“Bariatric surgery increases the risk of subsequent acute liver injury and mortality associated with acute liver injury,” Wander concluded. “Addressing modifiable risk factors, such as anemia, malnutrition and alcoholism, in post-bariatric surgery population will decrease the significant morbidity and mortality of acute liver injury.” – by Talitha Bennett

References:

Wander P, et al. Abstract 278. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Disclosure : Wander reports no relevant financial disclosures.

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