Bariatric surgery may prevent strokes and extend life expectancy
19 November 2019
This is hot-off-the-press research and as robust as you can get it! I say that because of the type of study it is and the length of time the patients have been followed up ie 11 years. It is what we call a Case-Control study - so every patient included in the study who has had Bariatric surgery is matched (for age, sex, BMI, smoking status etc) with somebody who hasn't had Bariatric surgery. This means, in essence, that their outcomes can be compared directly because the only thing that is different between the matched patients is whether they have had surgery or not. And what a stunning result - 69% less likely to have a Stroke and 68% less likely to die in the study period. Wow! There is no other treatment that can give as significant a health benefit as Weight loss surgery that I know of! Well and truly dispelling the long held myth that Weight loss surgery is an aesthetic procedure. Seems laughable now in light of these kinds of results.
Hope this helps you in your decision making process!
Patients with obesity who undergo bariatric surgery live longer and are less likely to experience a clot-caused stroke than those who do not, according to preliminary research to be presented at the American Heart Association's Scientific Sessions 2019, in Philadelphia.
"Obesity is associated with a number of risk factors for heart disease and we know that bariatric surgery - which alters the digestive system to induce weight loss - can help reduce these risk factors and improve their control. In this study, we examined if bariatric surgery helps reduce stroke risk," said Dr Maddalena Ardissino, co-lead author of the study and academic foundation doctor at the Imperial College London in the United Kingdom.
In the largest and longest study of bariatric surgery to-date, researchers analysed the health care records of more than 4,200 patients in the UK who had bariatric surgery and compared them to an equal number of people who did not have bariatric surgery, matched by age, gender and weight-for-height. At the time of the surgery, none of the participants had previously had a stroke. The records were part of the Clinical Practice Research Datalink, a large ongoing initiative that contains anonymous coded primary and some secondary health care data on more than 7% of all patients in the country.
During an average follow-up of 11 years and after adjusting for all major risk factors and medication use, researchers found:
- 73 of the participants had a brain bleed, clot-caused stroke or mini-stroke;
- 229 patients died from any cause;
- Those who received bariatric surgery were 69% less likely to experience a clot-caused stroke;
- Rates of brain bleeds were not reduced by weight loss surgery; and
- Those who underwent bariatric surgery were 68% less likely to die during the follow-up period than those who did not have surgery.
"These findings call for increased awareness and implementation of bariatric surgery as a treatment step for obese patients who are unable to achieve adequate weight loss through lifestyle and medication therapy," said Ardissino. "Currently, only a small fraction of people with obesity receive bariatric surgery."
A shift in the perception of bariatric surgery is needed. Bariatric surgery used to be seen as an aesthetic procedure undergone by only a minority of the eligible population. Considering the quickly emerging evidence on its long-term benefits, the surgery must be viewed as a potentially death-preventing and standard-of-care procedure that should be discussed with all eligible patients, Ardissino add.
This study can only show an association and cannot prove cause-and-effect. Although the data was from the UK, researchers say the results should apply to other western countries with similar populations.
Health-related quality of life, sexuality and hormone status after laparoscopic Roux-En-Y gastric bypass in women
29 October 2019
Quality of life scoring after surgical interventions is something that is often overlooked in the medical world. Although for a lot of patients the improvement in quality of life aspects of significant weight loss following Bariatric surgery (Gastric Bypass, Sleeve or Band) are just as important. All of the data is subjective but self reporting of these types of parameters are the most accurate way of getting objective evidence of benefit. I think the corollary of those who notice improvements are those who notice no improvements - and there are a significant proportion of these women. This could be for 2 reasons - they didn't have an issue with these things prior to surgery anyway or they did have deficits but didn't notice any change.
Interesting research all the same.
Feel free to contact me if you have any questions regarding this or any other parts of the Bariatric surgery process.
Patients with Atrial Fibrillation perform better after Bariatric Surgery
22 October 2019
This is a hot-off-the-press article comparing how effective treatment for atrial fibrillation is in patients who have lost weight after bariatric surgery compared with obese patients who haven't had weight loss surgery. It is good quality science because it's from a single hospital and compares two groups of patients with the only variable being whether they have had bariatric surgery or not. There's a good correlation between having had significant weight loss from weight loss surgery and successful treatment for Atrial fibrillation. This suggests that taking off the weight eases the overall stress on the heart and improves cardiac function. Something we knew but is a nice demonstration of the beneficial effects of surgery.
Given the link between morbid obesity and unacceptable high recurrence rates after atrial fibrillation (AF) ablation—as well as the recent revelation that risk-factor modification plays a role in reducing arrhythmia recurrence post-ablation—researchers undertook a single-center observational cohort study to compare recurrence rates of arrhythmia in morbidly obese patients who underwent prior bariatric surgery (BS) with those of nonobese patients after AF ablation in addition to morbidly obese patients who did not undergo BS. They found a link between bariatric surgery and a reduction in arrhythmia recurrence post-ablation for AF in morbidly obese patients compared with those of nonobese patients. Experts recommended considering morbidly obese patients for BS prior to AF ablation.
Circulation: Arrhythmia and Electrophysiology — Donnellan E, Wazni O, Kanj M, et al. | October 17, 2019
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