The impact of bariatric surgery on hospitalization due to peripheral artery disease and critical limb ischemia: a nationwide analysis.

Severe obesity could be an independent risk factor for peripheral artery disease (PAD) and critical limb ischemia (CLI). Bariatric surgery reduces cardiac risk factors, decreasing cardiovascular morbidity and mortality in subjects with severe obesity. We aimed to describe the impact of bariatric surgery on risk of hospitalization due to PAD and CLI. Academic hospital. The National Inpatient Sample data collected from 2010 to 2015 were examined. Patients were classified as treatment and control groups. Treatment was defined as patients with a previous history of bariatric surgery, and control was defined as patients with a body mass index ≥35 without a history of bariatric surgery. The primary outcome was hospitalization due to PAD; secondary outcomes were CLI, revascularization, major amputation, length of hospital stay (LOS), and total cost of hospitalization. Univariate and multivariate analyses were performed to assess the differences between groups. 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 (.10% versus.21%, P <.0001), which was confirmed after adjusting for covariables (control versus treatment: odds ratio= 1.20, confidence interval: 1.15-1.47). Subgroup analysis showed patients without a history of bariatric surgery had a higher prevalence of CLI (59.3% versus 52.4%, P <.0219) and a higher mean LOS (6.7 versus 5.7 days, P =.0023) and cost of hospitalization (78.756 versus 72.621$, P =.0089), with no significant differences in other outcomes. After multivariate analysis, only LOS and total costs were significantly different. Bariatric surgery may decrease the risk of hospitalization due to PAD, similarly to the LOS and total cost of hospitalization. Prospective studies should be performed to describe this relationship. • Bariatric Surgery may decrease the risk of hospitalization due to Peripheral Artery Disease. • Length of hospital stay and cost of hospitalization, is significantly decreased in patients with history of Bariatric Surgery. • The prevalence of Critical limb ischemia is significantly lower in patients who had undergone bariatric surgery interventions. [ABSTRACT FROM AUTHOR]