Association of bariatric surgery with adverse outcomes in patients with nonalcoholic steatohepatitis

JAMAAminian A, Al-Kurd A, Wilson R, et al. | November 29, 2021


In patients having nonalcoholic steatohepatitis (NASH) and obesity, a significantly lower risk of incident major adverse liver outcomes and major adverse cardiovascular events was observed in relation to bariatric surgery vs nonsurgical management.

  • This is a retrospective cohort analysis of 1,158 patients with obesity and biopsy-proven fibrotic NASH without cirrhosis.

  • A total of 650 patients who had bariatric surgery and 508 patients in the nonsurgical control group, with a median follow-up of 7 years (IQR, 4-10 years), were examined.

  • Bariatric surgery was found to be significantly linked with a lower risk of major adverse liver outcomes (adjusted absolute 10-year risk difference of 12.4%) and major adverse cardiovascular events (adjusted absolute 10-year risk difference of 13.9%).

  • Within the first year post-bariatric surgery, deaths due to surgical complications occurred in 4 patients (0.6%).

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