Abstract 9711: Association of Preoperative Body Mass Index With 30-Day Major Adverse Cardiovascular Events After Bariatric Surgery

Introduction: Despite bariatric surgery is the most effective and durable treatment for clinically morbid obesity, its association with intraoperative or 30-Day postoperative cardiovascular events after bariatric surgery is unclear. Hypothesis: To examine the association of preoperative body mass index (BMI) with adverse intraoperative or 30-day postoperative cardiovascular events after bariatric surgery. Methods: Our study extracted data from 785 321 patients who underwent bariatric surgery from 2015 to 2019 in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), which covers more than 90% of all bariatric surgery programs in the United States and Canada. The exposures were preoperative BMI and highest recorded preoperative BMI. The main outcomes were intraoperative or 30-day postoperative major adverse cardiovascular events (MACE). Results: Of the 785 321 patients (mean [SD] age 44.8 [11.8] years; 79.9% women), 1 541 patients suffered at least one MACE event intraoperative or 30-day postoperative bariatric surgery. Compared with patients with a preoperative BMI of 35.0 to 39.9, the multivariable-adjusted ORs (95% CIs) for intraoperative or 30-day postoperative MACE events for patients with preoperative BMI of 40.0 to 44.9, 45.0 to 49.9, 50.0 to 54.9, and 55.0 and greater were 1.05 (95% CI, 0.91-1.21), 1.19 (95% CI, 1.02-1.38), 1.28 (95% CI, 1.07-1.53), and 1.77 (95% CI, 1.50-2.09), respectively ( P for trend < 0.001). Moreover, compared with highest recorded preoperative BMI of 35.0 to 39.9, the multivariable-adjusted ORs (95% CIs) for intraoperative or 30-day postoperative MACE events for patients with preoperative BMI of 40.0 to 44.9, 45.0 to 49.9, 50.0 to 54.9, and 55.0 and greater were 1.20 (95% CI, 1.01-1.41), 1.18 (95% CI, 0.99-1.40), 1.32 (95% CI, 1.09-1.59), and 1.76 (95% CI, 1.48-2.10), respectively ( P for trend < 0.001). Conclusions: In this study, we found that higher preoperative BMI and higher highest recorded BMI were both associated with a higher risk of MACE events intraoperative or 30-day postoperative bariatric surgery. These findings may help improve perioperative cardiovascular optimization and provide evidence for future updates of clinical guidelines regarding bariatric surgery.