The Effect of Fasting during Ramadan on Outcomes after Bariatric Surgery at an Academic Medical Center in the Middle Eas
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The Effect of Fasting during Ramadan on Outcomes after Bariatric Surgery at an Academic Medical Center in the Middle East Christine Tat 1 & Juan S. Barajas-Gamboa 1 & Gabriel Diaz Del Gobbo 1 & Michael Klingler 2 & Mohammed Abdallah 1 & Javed Raza 1 & Carlos Abril 1 & Ricard Corcelles 1 & Matthew Kroh 1,2,3,4 Received: 17 May 2020 / Revised: 30 June 2020 / Accepted: 6 July 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Ramadan is characterized by a month of fasting between dawn and sunset. Cleveland Clinic Abu Dhabi is located in the United Arab Emirates, where the majority of our patients observe Ramadan. In many practices, bariatric surgery has been delayed until after Ramadan in order to avoid postoperative complications. However, there are no studies that evaluate this theory. Objectives Our study aimed to evaluate perioperative outcomes between bariatric surgeries performed before/during Ramadan and at times distant to Ramadan. Methods All patients who underwent primary bariatric surgery at Cleveland Clinic Abu Dhabi between September 2015 and July 2019 were retrospectively reviewed. The Pre-Ramadan (PR) cohort included patients that underwent surgery during the month of Ramadan and up to 3 months before Ramadan. The Non-Ramadan (NR) cohort included patients from the remainder 8 months. Results Our study included 542 patients: 185 patients in the PR cohort and 357 patients in the NR cohort. Baseline characteristics were similar. There were no statistically significant differences in perioperative outcomes, including emergency department (ED) visits (23.2% PR vs. 24.4% NR, p = .77), readmission rates (2.2% PR vs. 4.5% NR, p = .17), reoperation (1.1% PR vs. 3.6% NR, p = .09), and complications within 30 days (3.8% PR vs. 7.0% NR, p = .13). Conclusions There is no difference among patients who undergo surgery before/during Ramadan and at times distant to Ramadan. Based on this data, there does not appear to be an increased risk of performing bariatric surgery prior to or during Ramadan in a comprehensive, multi-disciplinary program. Keywords Ramadan . Bariatric surgery . Obesity . Metabolic surgery . Complications
Introduction In the Middle East, a large population annually observes the Holy Month of Ramadan. Ramadan is one of the sacred pillars of Islam. It is characterized by a month of fasting between * Matthew Kroh [email protected]; [email protected] 1
Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
2
Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
3
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
4
Digestive Disease Institute, Cleveland Clinic Abu Dhabi, PO Box: 112412, Abu Dhabi, United Arab Emirates
dawn and sunset for adult Muslims. Muslims abstain from all food and water during this period [1]. Typically, Muslims consume a pre-dawn meal (Suhur). Following the fast, they consume a second large meal a
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