Orthostatic Intolerance after Bariatric Surgery: a Systematic Review

Area of Science:

• Bariatric Surgery Outcomes
• Cardiovascular Physiology

Background:

• Orthostatic intolerance (OI) is a potential complication following bariatric surgery (BS).
• The predisposing factors for new-onset OI post-BS remain largely unknown.
• Understanding these factors is crucial for patient management and improving outcomes.

Purpose of the Study:

• To systematically review and summarize existing data on new-onset orthostatic intolerance after bariatric surgery.
• To identify potential predisposing factors and associated comorbidities.

Main Methods:

• A systematic literature search was conducted up to July 30, 2020.
• Studies were screened and selected based on predefined eligibility criteria.
• Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Main Results:

• Four studies met the inclusion criteria, involving predominantly female patients (83.3%).
• Commonly reported comorbidities included hypertension, type 2 diabetes mellitus, and obstructive sleep apnea syndrome.
• Information on surgical revisions, conversions, or reversals was not documented in the included studies.

Conclusions:

• New-onset orthostatic intolerance following bariatric surgery is an emerging concern.
• Hypertension, type 2 diabetes, and obstructive sleep apnea are frequently associated comorbidities.
• Increased awareness is necessary to mitigate risks of syncope and reduced quality of life.