Obesity Hypoventilation Syndrome and Postsurgical Outcomes in a Bariatric Surgery Cohort

Abstract

Purpose Patients with obesity and elevated serum bicarbonate suggesting obesity hypoventilation syndrome (OHS) undergoing bariatric surgery may represent a unique subgroup. Information regarding surgical outcomes in this population remains limited. We sought to test the hypothesis that an elevated bicarbonate would be an important predictor of perioperative complications (i.e., length of hospital stay) and postsurgical outcomes (i.e., weight loss at 1 year). Materials and Methods Consecutive patients undergoing bariatric surgery between January 2015 and December 2018 were included. Patients with a preoperative serum bicarbonate ≥ 27 mEq/L were classified as suspected OHS. Results Of 297 patients, the prevalence of suspected OHS based on an elevated bicarbonate was 19.5% (95% CI: 15.3 to 24.6%). Length of hospital stay was similar in the suspected OHS and non-OHS control group (1.50 vs 1.49 days, P = 0.98). The achieved weight loss from peak preoperative weight to 1 year post-surgery was less in the suspected OHS vs the control group (4.2% [95% CI 1.6 to 6.8]; P = 0.002). Conclusion Patients with serum bicarbonate ≥ 27 mEq/L as a surrogate marker for OHS experienced weight loss that was significantly less than their normal serum bicarbonate counterparts, but still achieved weight loss deemed clinically important by current guidelines. We observed no significant difference in length of hospital stay at time of surgery. Graphical abstract

Highlights vom DGP-Kongress 2024 aus Sicht der YoungDGP

“…Therapeutischer Standard bleibt die nicht-invasive Beatmungstherapie, deren Adhärenz mit der einer CPAP-Therapie vergleichbar ist [30]. Eine bariatrische OP bei Vorliegen eines OHS scheint ähnlich sicher, wie bei Patienten ohne diese Komorbidität, auch wenn der anschließende Gewichtsverlust bei OHS Patienten geringer ausfällt [31,32]. Bei Frauen besteht, gemäß einer Metaanalyse von Risi et al eine vergleichbare Effektivität der OP, im Langzeitverlauf aber ein ca.…”

Sleep Apnea, Obesity, and Diabetes — an Intertwined Trio

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