title: No more broken hearts: weight loss after bariatric surgery returns patients' postoperative risk to baseline following coronary surgery.
abstract: BACKGROUND
  The obesity epidemic is associated with a rise in coronary surgeries because obesity is a risk factor for coronary artery disease. Bariatric surgery is linked to improvement in cardiovascular co-morbidities and left ventricular function. No studies have investigated survival advantage in postoperative bariatric patients after coronary surgery.
  
  
  OBJECTIVE
  To determine if there is a benefit after coronary surgery in patients who have previously undergone bariatric surgery.
  
  
  METHODS
  National Inpatient Sample.
  
  
  METHODS
  We performed a retrospective, cross-sectional analysis of the National Inpatient Sample database from 2003 to 2010. We selected bariatric surgical patients who later underwent coronary surgery (n = 257). A comparison of postoperative complications and mortality after coronary surgery were compared with controls (n = 1442) using χ2tests, linear regression analysis, and multivariate logistical regression models.
  
  
  RESULTS
  A subset population was identified as having undergone coronary surgery (n = 1699); of this population, 257 patients had previously undergone bariatric surgery. They were compared with 1442 controls. The majority was male (67.2%), white (82.6%), and treated in an urban environment (96.8%). Patients with bariatric surgery assumed the risk of postoperative complications after coronary surgery that was associated with their new body mass index (BMI) (BMI<25 kg/m2: odds ratio (OR) 1.01, 95% CI .76-1.34, P = .94; BMI 25 to<35 kg/m2: OR .20, 95% CI .02-2.16, P = .19; BMI≥35 kg/m2: OR>999.9, 95% CI .18 to>999.9, P = .07). Length of stay was significantly longer in postbariatric patients (BMI<25, OR 1.62, 95% CI 1.14-2.30, P = .007).
  
  
  CONCLUSIONS
  Postoperative bariatric patients have a return to baseline risk of morbidity and mortality after coronary surgery.
authors.affiliation: Department of Surgery, Division of General Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Maria
authors.initials: M
authors.lastname: Baimas-George
authors.affiliation: Department of Surgery, Division of General Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Dietric L
authors.initials: DL
authors.lastname: Hennings
authors.affiliation: Department of Surgery, Division of General Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Al-Qurayshi
authors.affiliation: Department of Surgery, Division of General Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors.lastname: Emad Kandil
authors.affiliation: Department of Surgery, Division of General Surgery, Tulane University School of Medicine, New Orleans, Louisiana. Electronic address: cducoin@tulane.edu.
authors.forename: Christopher
authors.initials: C
authors.lastname: DuCoin
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000191:economics / Q000706:statistics & numerical data*; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000517:prevention & control / Q000601:surgery; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D011182:Postoperative Care / Q000191:economics / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology; D012307:Risk Factors; D024162:Second-Look Surgery / Q000191:economics / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States; D015431:Weight Loss / Q000502:physiology
keywords: BMI; bariatric surgery; coronary surgery; obesity