The impact of prior BS on cardiac surgery outcomes in patients with type 2 diabetes mellitus: a retrospective analysis of the nationwide inpatient sample

Background: Obesity and diabetes are risk factors for significant perioperative adverse outcomes. This study aims to assess the correlation between previous bariatric surgery (prior-BS) and perioperative complication outcomes after cardiac surgery in patients with type 2 diabetic mellitus (T2DM). Methods: Utilisation of the National Inpatient Sample Database to identify patients with T2DM undergoing major heart surgery from 2020 to 2022. Patient demographics, hospital attributes, concomitant conditions, complications, and additional postoperative outcomes were evaluated. Propensity score matching analysis was employed to equilibrate baseline disparities. Multivariate logistic regression analyses were utilised to assess the risk of postoperative outcomes in individuals having a history of BS compared to those with morbid obesity. Results: After PSM, a total of 7,732 patients were analyzed, with 3,866 patients in each group. Compared to patients with morbid obesity, those with a history of prior- BS had lower risks of in-hospital mortality, acute kidney injury, acute myocardial infarction, pneumonia and sepsis, and prior-BS was associated with increased risks of wound infection. Conclusions: Prior-BS surgery in patients with type 2 diabetes mellitus undergoing heart surgery is correlated with a reduced risk of complications. This crucial differentiation could improve risk classification and management for individuals with T2DM prior to heart surgery.