Background

Cardiac arrest is a major public health problem. Bariatric Surgery (BaS) patients are a high risk population for developing cardiopulmonary complications leading to this adverse outcome. We aimed to describe patient and procedure related factors that may increase the risk of cardiac arrest after elective primary laparoscopic BaS.

Methods

We performed a retrospective analysis of the MBSAQIP database for patients aged ≥18 years old undergoing laparoscopic sleeve gastrectomy (SG) and Roux en Y gastric bypass (GBP) during 2015-2019. Data on demographics, comorbidities and type of procedure were collected. The primary outcome of the study was the incidence of cardiac arrest. Secondary outcomes included 30-day complications, readmission, reoperation and mortality. Univariate analysis was performed to look for any differences between patients with and without cardiac arrest; a multivariate logistic regression model was performed to determine clinical predictors.

Results

A total of 752,722 patients were included in our analysis. Cardiac arrest occurred in 296 patients (0.04%). Univariate analysis showed that patients with postoperative cardiac arrest had higher rates of adverse 30-days outcomes (Table 2), with a mortality rate as of 56.4%. Multivariable analysis revealed the most important predictors of cardiac arrest: end stage renal disease on hemodialysis, therapeutic anticoagulation, male gender, history of chronic kidney disease and chronic obstructive pulmonary disease (Table 3).

Conclusions

Cardiac arrest is associated with significantly adverse 30-day outcomes in patients undergoing BaS. Our analysis also showed that a history of end stage renal disease on hemodialysis was the most relevant independent predictor of cardiac arrest.