According to a recent study, bariatric surgery reduces the risk of an emergency department visit or hospitalization for asthma exacerbation in obese patients, suggesting effectiveness of weight loss on asthma morbidity. The study titled “Risk of an asthma exacerbation after bariatric surgery in adults” was recently published in The Journal of Allergy and Clinical Immunology.
Asthma and obesity are important public health problems in the United States. Asthma affects about 26 million Americans, and estimates show 35% of American adults are obese. Previous studies have shown associations between obesity and the development of asthma, risk of exacerbations, and higher risk of hospitalization, making it a problem in asthma management and in overall healthcare. However, little is known about the effect of weight reduction on asthma morbidities.
Kohei Hasegawa from the Department of Emergency Medicine at Massachusetts General Hospital and colleagues sought to examine if bariatric surgery is associated with a rapid and sustained decrease in risk of asthma exacerbation. To do this, the researchers conducted self-controlled case series studies of 2,261 obese patients with asthma, aged 18 to 54 years, and elected bariatric surgery using the population-based emergency department (ED) and inpatient sample in the states of California, Florida, and Nebraska.
The study’s primary outcome was an ED visit or hospitalization for asthma exacerbation from 2005 through 2011. The researchers then compared each patient’s risk of experiencing an asthma attack 13-24 months before the surgery, with the risk 12 months after the procedure.
Results revealed that 13 to 24 months before surgery, 22% of patients needed at least one ED or hospitalization for asthma exacerbation. In the year before surgery, the risk for an ED visit or hospitalization persisted after 24 months. However, at 12 months after the surgery, the risk for an ED visit or hospitalization for asthma exacerbation declined to 10.9% of patients and stayed the same 24 months later.
The researchers concluded: “Because the benefit of bariatric surgery might be offset by the initial high cost and risks of surgical complications, our finding also emphasizes the importance of safe, effective, nonsurgical approaches to achieve major weight loss, which would likely benefit millions of obese patients with asthma.”