Purpose Prevalence of obesity in liver transplant recipients is increasing with the overall epidemic augmentation of severe obesity, the effects of immunosuppressive drugs, and lifestyle changes which are responsible for de novo obesity development or aggravation of pre-existing obesity. The aim of this study is to analyze the differences in overall mortality, re-hospitalization rate, and hospitalization-related costs between patients undergoing bariatric surgery after liver transplantation and patients undergoing bariatric surgery alone.Materials and Methods Twenty patients with history of liver transplantation who underwent bariatric surgery were analyzed from the French National Hospital Discharge Database. Overall mortality, re-hospitalization rate, length of stay for bariatric procedure, and the costs of bariatric surgery hospitalization and eventual re-hospitalizations were compared to a group of 360,846 patients who underwent bariatric surgery alone from 2010 to 2019. Furthermore, a 1:1 propensity score matching analysis was conducted.Results Patients with a history of liver transplantation showed an increased risk of overall mortality (HR: 7.66, p = 0.0047) and increased costs of hospitalization for bariatric surgery (8250 +/- 4822(sic) vs 5583 +/- 3398(sic), p = 0.0005). No differences in length of stay, re-hospitalization rate, and costs were found after multivariate analysis. After propensity score matching analysis, a significant increased cost of hospitalization (8250 +/- 4822(sic) vs 6086 +/- 1813(sic), p = 0.0195) still resulted for the liver transplantation group.Conclusion Bariatric surgery represents the best treatment for obesity and its related associated medical problems. Our study highlights an increased risk of overall all-cause mortality and increased costs of hospitalization in this population compared to patients undergoing bariatric surgery alone.

Clinical and Economic Impact of Bariatric Surgery Post Liver Transplantation: a Nationwide, Population-Based Retrospective Study / Chierici, Andrea; Bulsei, Julie; Castaldi, Antonio; Petrucciani, Niccolo; Drai, Céline; Schneck, Anne-Sophie; Chevalier, Nicolas; Fontas, Eric; Iannelli, Antonio. - In: OBESITY SURGERY. - ISSN 0960-8923. - 32:8(2022). [10.1007/s11695-022-06120-x]

Clinical and Economic Impact of Bariatric Surgery Post Liver Transplantation: a Nationwide, Population-Based Retrospective Study

Petrucciani, Niccolo;
2022

Abstract

Purpose Prevalence of obesity in liver transplant recipients is increasing with the overall epidemic augmentation of severe obesity, the effects of immunosuppressive drugs, and lifestyle changes which are responsible for de novo obesity development or aggravation of pre-existing obesity. The aim of this study is to analyze the differences in overall mortality, re-hospitalization rate, and hospitalization-related costs between patients undergoing bariatric surgery after liver transplantation and patients undergoing bariatric surgery alone.Materials and Methods Twenty patients with history of liver transplantation who underwent bariatric surgery were analyzed from the French National Hospital Discharge Database. Overall mortality, re-hospitalization rate, length of stay for bariatric procedure, and the costs of bariatric surgery hospitalization and eventual re-hospitalizations were compared to a group of 360,846 patients who underwent bariatric surgery alone from 2010 to 2019. Furthermore, a 1:1 propensity score matching analysis was conducted.Results Patients with a history of liver transplantation showed an increased risk of overall mortality (HR: 7.66, p = 0.0047) and increased costs of hospitalization for bariatric surgery (8250 +/- 4822(sic) vs 5583 +/- 3398(sic), p = 0.0005). No differences in length of stay, re-hospitalization rate, and costs were found after multivariate analysis. After propensity score matching analysis, a significant increased cost of hospitalization (8250 +/- 4822(sic) vs 6086 +/- 1813(sic), p = 0.0195) still resulted for the liver transplantation group.Conclusion Bariatric surgery represents the best treatment for obesity and its related associated medical problems. Our study highlights an increased risk of overall all-cause mortality and increased costs of hospitalization in this population compared to patients undergoing bariatric surgery alone.
2022
Bariatric surgery; Cost; Liver transplantation; Mortality; Obesity
01 Pubblicazione su rivista::01a Articolo in rivista
Clinical and Economic Impact of Bariatric Surgery Post Liver Transplantation: a Nationwide, Population-Based Retrospective Study / Chierici, Andrea; Bulsei, Julie; Castaldi, Antonio; Petrucciani, Niccolo; Drai, Céline; Schneck, Anne-Sophie; Chevalier, Nicolas; Fontas, Eric; Iannelli, Antonio. - In: OBESITY SURGERY. - ISSN 0960-8923. - 32:8(2022). [10.1007/s11695-022-06120-x]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1705145
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