P4600 - Bariatric Surgery Outcomes in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Patients: Propensity Matched Analysis of a Large Multi-Institutional Cohort

Amna Iqbal, MD¹, Waqas Rasheed, MD², Hassam Ali, MD³, Umar Hayat, MD⁴, Rayna Patel, MD¹, Aqsa Khan, MD⁵, Zohaib Ahmed, MD¹, Vishali Moond, MD⁶, Dushyant S. Dahiya, MD⁷, Priyanka Ahuja, MD⁸, Rehmat Ullah Awan, MD⁹, Shailendra Singh, MD⁹, Ali Nawras, MD^1
1University of Toledo Medical Center, Toledo, OH; ²University of Kentucky, Lexington, KY; ³ECU Health Medical Center, Greenville, NC; ⁴Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA; ⁵Parkview Health Center, Fort Wayne, IN; ⁶Saint Peter's University Hospital, New Brunswick, NJ; ⁷The University of Kansas School of Medicine, Kansas City, KS; ⁸University of Toledo, Toledo, OH; ⁹West Virginia University, Morgantown, WV

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) formerly non-alcoholic fatty liver disease (NAFLD), has become the most common chronic liver disease worldwide owing to increased rates of obesity and Western diet. Lifestyle modifications with weight loss and physical activity can reduce and reverse liver injury in patients with MASLD. With advances in bariatric surgery procedures, it is paramount to evaluate bariatric surgery outcomes on MASLD disease burden.

Methods: The multi-institutional research network TriNetX US Collaborative Network was used to identify patients with adult MASLD patients (aged 18 or above) who underwent bariatric surgery and patients who did not. After crude analysis, a propensity score matched (PSM) analysis was performed using demographic variables, history of obesity, mood disorders, prediabetes and other comorbidities as covariates to control for confounders. A two-sided P-value ≤ 0.05 was set as a threshold for statistical significance.

Results: A total of 37,014 MASLD patients with bariatric surgery (BSG) and 143,014 patients without bariatric surgery (NBSG) were identified. . At baseline, patients with BSG were younger, had lower rates of obesity, HTN, CVA, PAD, mood disorders and socioeconomical issues (Table 1). All study characteristics were well balanced in the propensity matched cohorts (Table 1).




In the matched cohort, there was a 20.9% lower association of all-cause mortality in BSG compared to NBSG (4.28% vs 5.35%; OR: 0.79, CI: 0.74-0.84). Similarly, there was a 40.2% lower association of advanced hepatic fibrosis (0.21% vs 0.35%; OR: 0.59, CI: 0.454-0.78), 19.7% lower association of hepatic encephalopathy (1.03% vs 1.28%; OR: 0.803, CI: 0.703-0.916), 20.8% lower association of spontaneous bacterial peritonitis (SBP) (0.86% vs 1.08%; OR: 0.792, CI: 0.686-0.916), 30.8% lower association of esophageal varices (1.32% vs 1.90%; OR: 0.692, CI: 0.618-0.775), and 46.7% lower association of acute myocardial infarction (MI) (0.42% vs 0.78%; OR: 0.533, CI: 0.44-0.645) in BSG compared to NBSG patients, respectively.

Discussion: Bariatric surgery in NAFLD patients is associated with low all-cause mortality, advanced hepatic fibrosis, hepatic encephalopathy, SBP, esophageal varices, DM and acute MI.



Disclosures:


Amna Iqbal, MD¹, Waqas Rasheed, MD², Hassam Ali, MD³, Umar Hayat, MD⁴, Rayna Patel, MD¹, Aqsa Khan, MD⁵, Zohaib Ahmed, MD¹, Vishali Moond, MD⁶, Dushyant S. Dahiya, MD⁷, Priyanka Ahuja, MD⁸, Rehmat Ullah Awan, MD⁹, Shailendra Singh, MD⁹, Ali Nawras, MD¹. P4600 - Bariatric Surgery Outcomes in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Patients: Propensity Matched Analysis of a Large Multi-Institutional Cohort, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.