Background

Severe obesity could be an independent risk factor for PAD and critical limb ischemia (CLI). Bariatric surgery (BaS) reduces cardiac risk factors, decreasing cardiovascular morbidity and mortality in severely obese subjects. We aimed to describe the impact of BaS on the risk of hospitalization due to PAD and CLI.

Methods

National Inpatient Sample (NIS) data collected from 2010 to 2015 was examined. Patients were classified as treatment and control groups. Treatment subjects were defined as patients with previous history of BaS, and control subjects as patients with BMI ≥ 35 without history of BaS. The primary outcome was hospitalization due to PAD, secondary outcomes were CLI, revascularization, major amputation, length of stay (LOS), and total cost of hospitalization. Univariate and multivariate analyses were performed to assess the differences between groups.

Results

There were a total of 2,300,845 subjects: 2,004,804 controls and 296,041 treatment patients. Hospitalization rate for PAD was significantly lower compared to the control group (0.10% vs. 0.21%, p<0.0001), which was confirmed after adjusting for covariables (control vs. treatment: OR = 1.20, CI: 1.15-1.47). Subgroup analysis showed that patients without history of BaS had higher prevalence of CLI (59.3% vs. 52.4%, p<0.0219), higher mean LOS (6.7 vs. 5.7 days, p=0.0023) and cost of hospitalization (78.756 vs. 72.621$, p=0.0089), with no significant differences in other outcomes. After multivariate analysis, only LOS and total costs were significantly different.

Conclusions

BaS may decrease the risk of hospitalization due to PAD, as well as the LOS and total cost of hospitalization.