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Cardiovascular, cancer and mortality events after bariatric surgery in people with and without pre-existing diabetes : a nationwide study
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Dhalwani, Nafeesa N., Zaccardi, Francesco, Waheed, Hina, Mytton, Jemma, Papamargaritis, Dimitris, Webb, David R., Evison, Felicity, Lilford, Richard, Davies, Melanie J. and Khunti, Kamlesh (2019) Cardiovascular, cancer and mortality events after bariatric surgery in people with and without pre-existing diabetes : a nationwide study. Journal of Diabetes, 11 (4). pp. 265-272. doi:10.1111/1753-0407.12851 ISSN 1753-0393.
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WRAP-cardiovascular-cancer-mortality-bariatric-surgery-diabetes-Lilford-2018.pdf - Accepted Version - Requires a PDF viewer. Download (2661Kb) | Preview |
Official URL: https://doi.org/10.1111/1753-0407.12851
Abstract
Background
Bariatric surgery reduces cardiovascular events and mortality risk in obese individuals. However, it is unclear whether diabetes modifies this effect. This study examined mortality, cardiovascular, and cancer risk following bariatric surgery in adults with and without pre‐existing diabetes.
Methods
Using mortality‐linked Hospital Episodes Statistics (2006‐14) from England, the risk of death, myocardial infarction, stroke, unstable angina, heart failure, and cancer following bariatric surgery was examined; the risk of death in people undergoing surgery was also compared with mortality rates of the general population.
Results
Of the 35 887 people undergoing bariatric surgery, 9175 (25.6%) had pre‐existing diabetes. During a mean follow‐up of 5.3 years, 801 people died, of whom 293 (36.6%) had pre‐existing diabetes. The risk of all‐cause mortality was 26% higher in people with than without diabetes (adjusted hazard ratio [aHR] 1.26, 95% confidence interval [CI] 1.08‐1.46), whereas the risk of cancer was 21% higher (aHR 1.21; 95% CI 1.14‐1.77). The risk of cardiovascular events was higher for patients with than without diabetes (aHRs [95% CIs] 2.08 [1.42‐3.05], 1.80 [1.29‐2.52], 1.61 [1.18‐2.19], and 1.42 [1.14‐1.77] for myocardial infarction, unstable angina, stroke, and heart failure, respectively). Compared with the general population, the age‐standardized mortality rate ratio was 1.70 (1.52‐1.91) and 1.35 (1.23‐1.48) in people with and without pre‐existing diabetes, respectively.
Conclusions
For patients with pre‐existing diabetes, the risk of death, cardiovascular events, and cancer after bariatric surgery was higher than for those without diabetes, whose mortality risk after surgery remains 35% higher than that of the general population.
| Item Type: | Journal Article | |||||||||||||||||||||||||||
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| Subjects: | R Medicine > RC Internal medicine | |||||||||||||||||||||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | |||||||||||||||||||||||||||
| Library of Congress Subject Headings (LCSH): | Diabetes, Cancer, Cardiovascular system -- Diseases, Obesity -- Surgery | |||||||||||||||||||||||||||
| Journal or Publication Title: | Journal of Diabetes | |||||||||||||||||||||||||||
| Publisher: | Wiley-Blackwell Publishing, Inc. | |||||||||||||||||||||||||||
| ISSN: | 1753-0393 | |||||||||||||||||||||||||||
| Official Date: | April 2019 | |||||||||||||||||||||||||||
| Dates: |
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| Volume: | 11 | |||||||||||||||||||||||||||
| Number: | 4 | |||||||||||||||||||||||||||
| Page Range: | pp. 265-272 | |||||||||||||||||||||||||||
| DOI: | 10.1111/1753-0407.12851 | |||||||||||||||||||||||||||
| Status: | Peer Reviewed | |||||||||||||||||||||||||||
| Publication Status: | Published | |||||||||||||||||||||||||||
| Access rights to Published version: | Restricted or Subscription Access | |||||||||||||||||||||||||||
| Date of first compliant deposit: | 23 November 2018 | |||||||||||||||||||||||||||
| Date of first compliant Open Access: | 7 September 2019 | |||||||||||||||||||||||||||
| RIOXX Funder/Project Grant: |
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