Aminian et al. (JAMA, 2021) investigated the long-term relationship between bariatric surgery and major adverse liver outcomes and major adverse cardiovascular events (MACE) in patients with obesity and NASH
Retrospective cohort study | SPLENDOR (Surgical Procedures and Long-term Effectiveness in NASH Disease and Obesity Risk) study
Patients undergoing liver biopsy at the Cleveland Clinic health system between 2004 and 2016
Follow up through March 2021
Adult patients with obesity
Confirmed histological diagnosis of NASH
Presence of liver fibrosis (histological stages 1-3)
Bariatric surgery with simultaneous liver biopsy
Roux-en-Y gastric bypass | Sleeve gastrectomy
Nonsurgical control group
Exposure and control groups were balanced for: Baseline clinical characteristics | Histological disease activity | Fibrosis stage
Regression analysis framework used for primary outcomes calculations
Major adverse liver outcomes
Progression to clinical or histological cirrhosis | Development of hepatocellular carcinoma | Liver transplantation | Liver-related mortality
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