A statewide hospital cohort described 34,738 adults undergoing primary sleeve gastrectomy in New South Wales between July 2017 and June 2022. Age-adjusted type 2 diabetes prevalence among them fell from 148.8 to 112.5 per 1,000. Men more often had two or more cardiovascular risk factors than women, 44.3% against 28.0%.
Why it is interesting: The clinical profile of those reaching bariatric surgery has shifted, with diabetes less common at operation.
Abstract — the authors' own words, CC BY
Background
Cardiometabolic conditions and frailty influence perioperative risk in bariatric surgery; however, contemporary population-level studies describing these factors are limited. This study characterised the cardiometabolic burden, comorbidity, and frailty of adults undergoing laparoscopic sleeve gastrectomy (LSG), with comparisons according to sex and hospital setting. Method
A population-based cohort study was conducted using statewide administrative hospital data from all public and private hospitals in New South Wales, Australia, between 1 July 2017 and 30 June 2022. Adults (≥18 years) undergoing primary LSG were included. The prevalence of cardiometabolic comorbidities and trends in age-adjusted disease rates were assessed. Subgroup analyses according to sex and hospital setting were performed for cardiovascular risk factors, comorbidity, and frailty. Results
Among 34,738 patients (78.3% female; 96.6% treated in private hospitals; mean age 41.3±11.5 years), nearly three-quarters (72.3%, n=25,130) had one or more cardiovascular risk factors. The prevalence of type 2 diabetes mellitus (T2DM) declined by 24.4% (148.8-112.5 per 1,000; p Conclusions
There was substantial variation in cardiometabolic burden among LSG recipients according to sex and hospital sector. The observed decline in T2DM suggests a change in the clinical profile of patients undergoing surgery. These findings warrant further investigation into the factors influencing access to surgery and patient selection.
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