Abstract 13185: Association Between Bariatric Surgery and Emergency Department Visits and Hospitalizations for Atrial Fibrillation
Introduction: Atrial fibrillation (AF) carries a large societal burden. Although studies suggested reduction of AF-related symptoms after bariatric surgery, little is known about whether bariatric surgery affects harder clinical endpoints related to AF.
Hypothesis: Bariatric surgery is associated with a reduction in the rate of ED visits and hospitalizations for AF.
Methods: We performed a self-controlled case series study of obese patients with AF who underwent bariatric surgery, using the population-based ED and inpatient sample in 3 states (California, Florida, and Nebraska). Primary outcome was ED visit or hospitalization for AF from 2005 to 2011. We used conditional logistic regression to compare each patient's rate of the outcome event during sequential 12-month periods, using pre-surgery months 13-24 as the reference period.
Results: We identified 1056 patients with AF who underwent bariatric surgery. During the reference period, 12.1% (95%CI, 10.1-14.0%) of patients had an ED visit or hospitalization for AF (Figure). The rate remained unchanged in the subsequent 12-month pre-surgery period (12.6%; 95%CI, 10.1-14.6%) with adjusted odds ratio [aOR] of 1.05 (95%CI, 0.81-1.36; P=0.74) compared to the reference period. In the first 12-month post-surgery period , we observed a similar rate of ED visits or hospitalizations for AF (14.2%; 95%CI, 12.1-16.3%), corresponding to aOR of 1.20 (95%CI, 0.93-1.55; P=0.16). The rate remained stable in the subsequent 13-24 months after bariatric surgery (13.4%; 95%CI, 11.3-15.4%), corresponding to aOR of 1.12 (95%CI, 0.87-1.45; P=0.40).
Conclusions: Our findings indicate that bariatric surgery is not associated with lower rates of AF episodes requiring ED evaluation or hospitalization among obese patients with AF. Our data facilitate further investigations to fill the gap between symptom improvement and lack of reduction in healthcare utilization in the high risk population with AF.
Author Disclosures: Y.J. Shimada: None. Y. Tsugawa: None. K. Hasegawa: None.
- © 2015 by American Heart Association, Inc.