S725 Impact of Prior Bariatric Surgery on Clinical Outcomes in Obese Patients Hospitalized for Acute Diverticulitis: A 5-Year National Inpatient Sample Analysis

Introduction: Obesity is a well-known risk factor for diverticular disease and its consequences. While bariatric surgery (BS) has shown significant advantages in reducing obesity-related comorbidities, its impact on acute diverticulitis outcomes is little understood. This research will look at the relationship of previous BS and clinical outcomes among obese individuals hospitalized for acute diverticulitis in the United States. Methods: We conducted retrospective cohort research using the National Inpatient Sample (NIS) from 2016 to 2020. Validated International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes were used to identify adult hospitalized patients (aged ≥18 years) with acute diverticulitis as their main diagnosis. Obesity and previous BS were diagnosed using secondary diagnostic codes. Primary outcomes were in-hospital mortality, intensive care unit (ICU) hospitalization, intestinal perforation, and colectomy. Secondary outcomes were length of stay (LOS) and inflation-adjusted total hospital expenses. Survey-weighted logistic and linear regression models were used, with adjustments for age, gender, race, insurance status, Charlson comorbidity index, income quartile, and hospital-level variables. Results: The final cohort included 45,238 obese people, with 12.2% having a documented history of BS. Patients with prior BS were substantially younger (mean age: 49.8 vs 55.4 years; P < 0.001) and more likely to be female (72% vs 58%). Prior BS was related to lower in-hospital mortality (adjusted odds ratio [aOR]: 0.58, 95% confidence interval [CI]: 0.46-0.70; P < 0.001) and ICU admission (aOR: 0.66, 95% CI: 0.54-0.78; P < 0.001). There was no significant difference in the rate of bowel perforation (aOR: 0.92, 95% CI: 0.80-1.04; P = 0.17) or colectomy (aOR: 0.93, 95% CI: 0.81-1.05; P = 0.23). Patients with a history of BS had a shorter average duration of stay (3.2 vs 4.5 days; adjusted β = -1.3; P < 0.001) and reduced hospital expenses ($16,840 vs $22,300; adjusted β = -$5,460; P < 0.001). Conclusion: Obese individuals hospitalized with acute diverticulitis who have had bariatric surgery had much better clinical outcomes and used fewer healthcare resources. These findings imply that BS may have a preventative advantage in acute colonic inflammatory disease and highlight its broader importance in lowering the severity of obesity-related gastrointestinal problems.