Prior Bariatric Surgery Predicts Lower Life-Threatening Morbidity in Patients Admitted for Acute Allergic Reaction and Anaphylaxis: a Propensity Score-Matched Analysis of the U.S. Nationwide Inpatient Sample, 2005-2018.
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引用次数: 0
Abstract
Purpose: Acute allergic reactions may occur in susceptible individuals following exposure to various allergens. Obesity is linked to allergic reactions, and weight loss from bariatric surgery may attenuate the severity of certain conditions such as airway hyperresponsiveness in asthma. This retrospective observational study investigates associations between prior bariatric surgery and lower risk for life-threatening conditions in patients hospitalized with acute allergic reactions and anaphylaxis.
Materials and methods: Adults ≥ 18 years old diagnosed with morbid obesity and admitted to US hospitals with acute allergic reactions/anaphylaxis were included. All data were extracted from the US Nationwide Inpatient Sample (NIS) database 2005-2018. Patients without information on in-hospital mortality, discharge destination, hospital costs, and length of stay (LOS) were excluded. Patients were divided into two groups based on prior bariatric surgery or not. All diagnoses were verified through ICD-9 and ICD-10 codes. Between-group differences and associations between variables were evaluated using logistic regression analysis.
Results: After matching, patients with prior bariatric surgery had significantly lower proportions of any life-threatening morbidity (37.2% vs. 47.4%), respiratory distress or failure (11.2% vs. 17.0%), pneumonia or severe infection (7.4% vs. 10.2%), sepsis/septic shock (15.2% vs. 20.9%), intubation and mechanical ventilation (11.2% vs. 14.6%), prolonged LOS (10.3% vs. 20.6%) and unfavorable discharge (6.9% vs. 12.5%) than those without prior bariatric surgery.
Conclusion: Prior bariatric surgery predicts a lower risk of life-threatening morbidity and prolonged LOS among adults hospitalized for acute allergic reaction and anaphylaxis. Future prospective studies are warranted to confirm the present findings and reveal underlying mechanisms.
目的：易感人群在接触各种过敏原后可能会发生急性过敏反应。肥胖与过敏反应有关，减肥手术减轻的体重可能会减轻某些疾病的严重程度，如哮喘的气道高反应性。这项回顾性观察研究调查了因急性过敏反应和过敏性休克而住院的患者中，曾接受减肥手术与降低危及生命的风险之间的关系：研究对象包括被诊断为病态肥胖且因急性过敏反应/过敏性休克在美国医院住院的年龄≥ 18 岁的成年人。所有数据均提取自2005-2018年美国全国住院患者样本（NIS）数据库。没有提供院内死亡率、出院目的地、住院费用和住院时间（LOS）信息的患者被排除在外。根据患者是否接受过减肥手术将其分为两组。所有诊断均通过 ICD-9 和 ICD-10 编码验证。采用逻辑回归分析评估组间差异和变量之间的关联：结果：经过匹配后，曾接受过减肥手术的患者中，任何危及生命的发病率（37.2% vs. 47.4%）、呼吸窘迫或衰竭（11.2% vs. 17.0%）、肺炎或严重感染（7.4% vs. 10.2%）、脓毒症（7.4% vs. 10.2%）的比例明显较低。结论：与未接受过减肥手术的患者相比，未接受过减肥手术的患者可能会出现呼吸窘迫或衰竭（11.2% vs. 17.0%）、肺炎或严重感染（7.4% vs. 10.2%）、败血症/脓毒性休克（15.2% vs. 20.9%）、插管和机械通气（11.2% vs. 14.6%）、住院时间延长（10.3% vs. 20.6%）和出院不顺利（6.9% vs. 12.5%）等症状：结论：在因急性过敏反应和过敏性休克住院的成人中，曾接受过减肥手术的患者发生危及生命的疾病和延长住院时间的风险较低。今后有必要开展前瞻性研究，以证实本研究结果并揭示其潜在机制。
期刊介绍：
Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions.
Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.
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