Does bariatric surgery change the risk of acute ischemic stroke in patients with a history of transient ischemic attack? A nationwide analysis
Copyright © 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Stroke is the second leading cause of death worldwide and fifth in the United States, and it represents the major cause of disability in older adults.
OBJECTIVE: We aimed to determine the risk of acute ischemic stroke (AIS) in individuals with obesity with a history of transient ischemic attack (TIA) compared with patients with a history of bariatric surgery.
SETTING: Academic hospital, United States.
METHODS: Using the Nationwide Inpatient Sample (NIS) database from 2010 to 2015, we retrospectively identified patients with obesity and past medical history of TIA and divided them into 2 groups: a treatment group of patients who underwent bariatric surgery, and a control group of patients with obesity. We compared incidence of new AIS in both groups using a univariate analysis and multivariate regression model. Covariates included were lifestyle (smoking status, alcohol habits, cocaine use), family history of stroke, co-morbidities (diabetes, hypertension, hyperlipidemia, atrial fibrillation) and long-term medical treatment (antiplatelet/antithrombotic treatment).
RESULTS: A total of 91,640 patients met inclusion criteria, of which treatment patients were 12.3% (n = 11,284) and control patients 87.6% (n = 80,356). The average age of the treatment group was 62.9 ± 17.08 years, and the average of the control was 59.6 ± 12.74 years. The rate of AIS in the treatment group was significantly lower compared with the control group (2.8% versus 4.2%, P < .0001). After adjusting for covariables, the risk difference of AIS was still significant between groups (odds ratio = 1.33, P < .0001), showing that patients in the treatment group were less likely to have AIS compared with the control group.
CONCLUSIONS: After analyzing nationwide information, we conclude bariatric surgery helps decrease risk of AIS in patients with a history of TIA. However, this comparison is limited by the nature of the database; further studies are needed to better understand these results.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
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| Enthalten in: |
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery - 19(2023), 6 vom: 27. Juni, Seite 548-554 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Valera, Roberto J [VerfasserIn] |
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| Links: |
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| Themen: |
Acute ischemic stroke |
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| Anmerkungen: |
Date Completed 29.05.2023 Date Revised 02.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.soard.2022.11.013 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM350928975 |
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| 100 | 1 | |a Valera, Roberto J |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Does bariatric surgery change the risk of acute ischemic stroke in patients with a history of transient ischemic attack? A nationwide analysis |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 29.05.2023 | ||
| 500 | |a Date Revised 02.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Stroke is the second leading cause of death worldwide and fifth in the United States, and it represents the major cause of disability in older adults | ||
| 520 | |a OBJECTIVE: We aimed to determine the risk of acute ischemic stroke (AIS) in individuals with obesity with a history of transient ischemic attack (TIA) compared with patients with a history of bariatric surgery | ||
| 520 | |a SETTING: Academic hospital, United States | ||
| 520 | |a METHODS: Using the Nationwide Inpatient Sample (NIS) database from 2010 to 2015, we retrospectively identified patients with obesity and past medical history of TIA and divided them into 2 groups: a treatment group of patients who underwent bariatric surgery, and a control group of patients with obesity. We compared incidence of new AIS in both groups using a univariate analysis and multivariate regression model. Covariates included were lifestyle (smoking status, alcohol habits, cocaine use), family history of stroke, co-morbidities (diabetes, hypertension, hyperlipidemia, atrial fibrillation) and long-term medical treatment (antiplatelet/antithrombotic treatment) | ||
| 520 | |a RESULTS: A total of 91,640 patients met inclusion criteria, of which treatment patients were 12.3% (n = 11,284) and control patients 87.6% (n = 80,356). The average age of the treatment group was 62.9 ± 17.08 years, and the average of the control was 59.6 ± 12.74 years. The rate of AIS in the treatment group was significantly lower compared with the control group (2.8% versus 4.2%, P < .0001). After adjusting for covariables, the risk difference of AIS was still significant between groups (odds ratio = 1.33, P < .0001), showing that patients in the treatment group were less likely to have AIS compared with the control group | ||
| 520 | |a CONCLUSIONS: After analyzing nationwide information, we conclude bariatric surgery helps decrease risk of AIS in patients with a history of TIA. However, this comparison is limited by the nature of the database; further studies are needed to better understand these results | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute ischemic stroke | |
| 650 | 4 | |a Bariatric surgery | |
| 650 | 4 | |a Severe obesity | |
| 650 | 4 | |a Transient ischemic attack | |
| 700 | 1 | |a Botero-Fonnegra, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Cogollo, Vicente J |e verfasserin |4 aut | |
| 700 | 1 | |a Sarmiento-Cobos, Mauricio |e verfasserin |4 aut | |
| 700 | 1 | |a Montorfano, Lisandro |e verfasserin |4 aut | |
| 700 | 1 | |a Rivera, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Hong, Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Lo Menzo, Emanuele |e verfasserin |4 aut | |
| 700 | 1 | |a Szomstein, Samuel |e verfasserin |4 aut | |
| 700 | 1 | |a Rosenthal, Raul J |e verfasserin |4 aut | |
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