Evidence map›Paper›PMID 31872338›Full record

ArticleObesity surgery2020

Laparoscopic Sleeve Gastrectomy Carries a Lower Perioperative Mortality Including Sudden Cardiac Death over Roux-en-Y Gastric Bypass in Patients with a Prior Cardiac History: An MBSAQIP Analysis.

Michael W Foster, Victoria M Gershuni, Colleen M Tewksbury, Jay S Giri, Kristoffel R Dumon, J Eduardo Rame, Noel N Williams

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Obesity surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Guideline
  2. Observational
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Michael W FosterDepartment of Surgery, Division of Gastrointestinal Surgery, Penn Metabolic and Bariatric Surgery Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. mfoster610@gmail.com.ORCID http://orcid.org/0000-0003-3675-8289
Victoria M GershuniDepartment of Surgery, Division of Gastrointestinal Surgery, Penn Metabolic and Bariatric Surgery Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Colleen M TewksburyDepartment of Surgery, Division of Gastrointestinal Surgery, Penn Metabolic and Bariatric Surgery Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Jay S GiriDepartment of Medicine, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Kristoffel R DumonDepartment of Surgery, Division of Gastrointestinal Surgery, Penn Metabolic and Bariatric Surgery Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
J Eduardo RameDepartment of Medicine, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Noel N WilliamsDepartment of Surgery, Division of Gastrointestinal Surgery, Penn Metabolic and Bariatric Surgery Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Hospital of the University of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough bariatric surgery has proven beneficial for those with cardiovascular disease (CVD), the overall and procedure-specific risk associated with bariatric surgery in this patient population remains unknown.

designPatients who underwent primary laparoscopic, laparoscopic-assisted, or robotic-assisted Roux-En-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) at a MBSAQIP-accredited center were included (n = 494,611). Exposures include history of MI, PCI, or cardiac surgery who underwent RYGB or SG. Outcome measures were 30-day mortality, perioperative cardiac arrest, and rehospitalization.

resultsOf 494,611 patients enrolled in MBSAQIP, 15,923 had a history of MI, PCI, or cardiac surgery (prior cardiac history). Patient history of MI, PCI, and cardiac surgery was associated with significantly increased adjusted risk of perioperative cardiac arrest requiring CPR (OR: 2.31, 2.12, 2.42, respectively) and adjusted 30-day mortality (OR: 1.72, 1.50, 1.68, respectively). Prior cardiac history was associated with increased adjusted 30-day readmission rate (MI - OR, 1.42; PCI - OR, 1.45; and cardiac surgery - OR, 1.68). Further, 30-day postoperative readmission, postoperative cardiac arrest, and death were lower for patients undergoing SG compared to RYGB (OR: 0.48, 0.49, and 0.54 respectively). CONCLUSION AND RELEVANCE: Prior cardiac history was associated with significant greater risk of perioperative cardiac arrest and 30-day mortality among patients undergoing bariatric surgery. SG was associated with less adverse events than RYGB among this population. While there is a clear benefit to weight loss in patients with CVD, it is important to consider whether cardiac patients considering bariatric surgery may require additional preoperative optimization, perioperative interventions, and postoperative monitoring.

Indexed as

AdultBariatric SurgeryDeath, Sudden, CardiacFemaleGastrectomyGastric BypassHeart DiseasesHumansLaparoscopyMaleMiddle AgedMortalityMyocardial InfarctionObesity, MorbidPatient ReadmissionPercutaneous Coronary InterventionBariatric surgeryCardiac surgeryMBSAQIPMortalityMyocardial infarctionPercutaneous coronary interventionRoux-en-Y gastric bypassSleeve gastrectomySudden cardiac death

Identifiers

PMID31872338
OpenAlexW2995266912

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.