The incidence of orthostatic intolerance after bariatric surgery.
bariatric surgery
incidence
orthostatic hypotension
Journal
Obesity science & practice
ISSN: 2055-2238
Titre abrégé: Obes Sci Pract
Pays: United States
ID NLM: 101675151
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
26
04
2019
revised:
22
09
2019
accepted:
07
10
2019
entrez:
5
3
2020
pubmed:
5
3
2020
medline:
5
3
2020
Statut:
epublish
Résumé
Every year, over 200 000 individuals undergo bariatric surgery for the treatment of extreme obesity in the United States. Several retrospective studies describe the occurrence of orthostatic intolerance (OI) syndrome after bariatric surgery. However, the incidence of this syndrome remains unknown. We used a prospective, de-identified registry of 4547 patients who have undergone bariatric surgery at Vanderbilt to identify cases of new-onset OI. Structured chart reviews were conducted for all subjects who reported new-onset OI post surgery. Cases of OI were confirmed using an operational case definition developed by the Vanderbilt Autonomic Dysfunction Center, and autonomic function tests results were examined for evidence of impaired autonomic function. The cumulative incidence of post-bariatric surgery OI syndrome was estimated using a life table. Seven hundred forty-one of 4547 (16.3%) patients included in our cohort reported new OI symptoms after surgery. After the chart review, we confirmed the presence of post-bariatric surgery OI syndrome in 85 patients, 14 with severe OI requiring pressor agents. At 5 years post surgery, follow-up is reduced to 15%; the unadjusted 5-year prevalence of OI was 1.9%. The cumulative incidence of OI syndrome adjusted for loss of follow-up was 4.2%. Most OI cases developed during weight-stable months (±5 kg). At the time of identification, 13% of OI cases showed evidence of impaired sympathetic vasoconstrictor activity. OI is frequent in the bariatric population, affecting 4.2% of patients within the first 5 years postoperatively. In 13% of post-bariatric surgery OI patients, there was evidence of impaired sympathetic vasoconstriction activity.
Identifiants
pubmed: 32128245
doi: 10.1002/osp4.383
pii: OSP4383
pmc: PMC7042102
doi:
Types de publication
Journal Article
Langues
eng
Pagination
76-83Informations de copyright
© 2019 The Authors. Obesity Science & Practice published by John Wiley & Sons Ltd, World Obesity and The Obesity Society.
Déclaration de conflit d'intérêts
The authors have nothing to disclose.
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