P2884 - Bariatric Surgery Associated With Improved Outcomes in Patients With Nonalcoholic Steatohepatitis: A Retrospective Analysis of the National Inpatient Sample Database (2016-2020)

Anuj R. Sharma, MBBS¹, Chaula Desai, MD¹, Suriya Baskar, MD¹, Manasa Ginjupalli, MBBS, MD², Vikash Kumar, MD³, Sweta Lohani, MBBS, MD¹, Saigopal R. Gujjula, MD¹, Iyad Al-bustami, MD, MPH(c)⁴, Jeeva Jaganathan, MD¹, Raissa Nana Sede Mbakop, MD⁵, Camelia Ciobanu, MD¹, Amr Dokmak, MD¹, Praneeth Bandaru, MBBS, MD¹, Vijay Reddy Gayam, MD⁶, Arnold N. Forlemu, MD, MPH⁷, Denzil Etienne, MD¹, Madhavi Reddy, MD, FACG^1
1Brooklyn Hospital Center, Brooklyn, NY; ²The Brooklyn Hospital Center, New York, NY; ³Creighton University School of Medicine, Brooklyn, NY; ⁴Brooklyn Hospital Center, Houston, TX; ⁵The Brooklyn Hospital Center, Brooklyn, NY; ⁶University of Texas Southwestern Medical Center, Dallas, TX; ⁷Brooklyn Hospital Center, Athens, GA

Introduction: Metabolic dysfunction-associated steatohepatitis (MASH), formerly Nonalcoholic steatohepatitis (NASH), a clinicopathological variant of Metabolic dysfunction-associated Steatotic Liver Disease (MASLD), with histological evidence of hepatic steatosis includes liver cell injury, steatohepatitis, and fibrosis. It is commonly seen in populations with metabolic syndrome. Pragmatically, some patients with MASH undergo bariatric surgery. This study aims to compare outcomes of MASH among patients who received bariatric surgery versus those who did not.

Methods: A retrospective analysis was performed using data from the National Inpatient Sample Database for the years 2016-2020. Inpatient admissions with a principal diagnosis of MASH were identified using ICD-10 codes. The association between bariatric surgery and MASH outcomes was studied. Categorical variables were compared using the chi-square test, while continuous variables were compared using the t-test. Multivariable regression analyses were performed, adjusting for demographics and relevant comorbidities. Confounding variables, including dyslipidemia, hypertension, diabetes, chronic kidney disease, congestive heart failure, coronary artery disease, and peripheral vascular disease, were adjusted using multivariate logistic and linear regression analyses.

Results: A total of 539,275 hospitalizations with MASH were identified, out of which 3.19% underwent bariatric surgery. On average, patients who underwent surgery were younger (55 years vs. 62 years) and were predominantly females (81.1% vs 61.2%). After adjusting for confounders, this group had lower inpatient mortality (Odds ratio (OR) 0.78; CI 0.63 – 0.97, p-value 0.027). They were also observed to be associated with lower odds of hepatocellular carcinoma (OR 0.51; CI 0.34 – 0.76, p-value < 0.001) and variceal bleeding (OR 0.48; CI 0.35 – 0.64, p-value < 0.001). Univariate analyses were significant for lower odds of cirrhosis(OR 0.7; CI 0.66-0.76, p-value < 0.001) and ascites (OR 0.76, CI 0.69-0.83, p-value < 0.001) with surgery

Discussion: Our study suggests that bariatric surgery can be a significant modifying factor and could be associated with better outcomes in MASH patients. This provides insight into guiding the management of MASH patients and could potentially minimize MASH-associated sequela.


Disclosures:


Anuj R. Sharma, MBBS¹, Chaula Desai, MD¹, Suriya Baskar, MD¹, Manasa Ginjupalli, MBBS, MD², Vikash Kumar, MD³, Sweta Lohani, MBBS, MD¹, Saigopal R. Gujjula, MD¹, Iyad Al-bustami, MD, MPH(c)⁴, Jeeva Jaganathan, MD¹, Raissa Nana Sede Mbakop, MD⁵, Camelia Ciobanu, MD¹, Amr Dokmak, MD¹, Praneeth Bandaru, MBBS, MD¹, Vijay Reddy Gayam, MD⁶, Arnold N. Forlemu, MD, MPH⁷, Denzil Etienne, MD¹, Madhavi Reddy, MD, FACG¹. P2884 - Bariatric Surgery Associated With Improved Outcomes in Patients With Nonalcoholic Steatohepatitis: A Retrospective Analysis of the National Inpatient Sample Database (2016-2020), ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.